WorldWideScience

Sample records for chronic respiratory symptoms

  1. 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...

  2. 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

  3. 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

  4. 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

  5. Welding, longitudinal lung function decline and chronic respiratory symptoms: a systematic review of cohort studies.

    Science.gov (United States)

    Szram, Joanna; Schofield, Susie J; Cosgrove, Martin P; Cullinan, Paul

    2013-11-01

    While the acute respiratory risks of welding are well characterised, more chronic effects, including those on lung function, are less clear. We carried out a systematic review of published longitudinal studies of lung function decline in welders. Original cohort studies documenting two or more sequential measurements of lung function were reviewed. Meta-analysis was carried out on studies with suitable data on forced expiratory volume in 1 s (FEV1). Seven studies were included; their quality (measured on the Newcastle-Ottawa scale) was good, although exposure assessment was limited and the studies showed significant heterogeneity. Five had data suitable for meta-analysis; the pooled estimate of the difference in FEV1 decline between welders and nonwelders was -9.0 mL · year(-1) (95% CI -22.5-4.5; p=0.193). The pooled estimates of difference in annual FEV1 decline between welders and referents who smoked was -13.7 mL · year(-1) (95% CI -33.6-6.3; p=0.179). For welders and referents who did not smoke the estimated difference was -3.8 mL · year(-1) (95% CI -20.2-12.6; p=0.650). Symptom prevalence data were mainly narrative; smoking appeared to have the greatest effect on symptom evolution. Collectively, available longitudinal data on decline of lung function in welders and respiratory symptoms suggest a greater effect in those who smoke, supporting a focus on smoking cessation as well as control of fume exposure in this trade. Further prospective studies are required to confirm these findings.

  6. Lung function reduction and chronic respiratory symptoms among workers in the cement industry: a follow up study

    Directory of Open Access Journals (Sweden)

    Zeleke Zeyede K

    2011-11-01

    Full Text Available Abstract Background There are only a few follow-up studies of respiratory function among cement workers. The main aims of this study were to measure total dust exposure, to examine chronic respiratory symptoms and changes in lung function among cement factory workers and controls that were followed for one year. Methods The study was conducted in two cement factories in Ethiopia. Totally, 262 personal measurements of total dust among 105 randomly selected workers were performed. Samples of total dust were collected on 37-mm cellulose acetate filters placed in closed faced Millipore-cassettes. Totally 127 workers; 56 cleaners, 44 cement production workers and 27 controls were randomly selected from two factories and examined for lung function and interviewed for chronic respiratory symptoms in 2009. Of these, 91 workers; 38 cement cleaners (mean age 32 years, 33 cement production workers (36 years and 20 controls (38 years were examined with the same measurements in 2010. Results Total geometric mean dust exposure among cleaners was 432 mg/m3. The fraction of samples exceeding the Threshold Limit Value (TLV of 10 mg/m3 for the cleaners varied from 84-97% in the four departments. The levels were considerably lower among the production workers (GM = 8.2 mg/m3, but still 48% exceeded 10 mg/m3. The prevalence of all the chronic respiratory symptoms among both cleaners and production workers was significantly higher than among the controls. Forced Expiratory Volume in one second (FEV1 and FEV1/Forced Vital Capacity (FEV1/FVC were significantly reduced from 2009 to 2010 among the cleaners (p Conclusions The high prevalence of chronic respiratory symptoms and reduction in lung function is probably associated with high cement dust exposure. Preventive measures are needed to reduce the dust exposure.

  7. 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

  8. Pesticides and respiratory symptoms among farmers

    Directory of Open Access Journals (Sweden)

    Faria Neice Müller Xavier

    2005-01-01

    Full Text Available OBJECTIVE: Despite the intensive use of pesticides in agriculture there are few studies assessing the risk of respiratory conditions from this exposure. The study aimed at quantifying the prevalence of respiratory symptoms among farmers and evaluating its relationship with occupational use of pesticides and the prevalence of respiratory symptoms. METHODS: A cross-sectional study was conducted among 1,379 farmers from two municipalities of Southern Brazil in 1996. Frequency and type of chemical exposure and pesticide poisoning were recorded for both sexes. All subjects aged 15 years or older with at least 15 weekly hours of agricultural activity were interviewed. An adapted questionnaire developed by the American Thoracic Society was used for the assessment of respiratory symptoms. Multivariate logistic regression analysis was carried out. RESULTS: More than half (55% of interviewees were male. The prevalence of asthma symptoms was 12% and chronic respiratory disease symptoms was 22%. Higher odds ratios for both asthma (OR=1.51; 95% CI: 1.07-2.14 and chronic respiratory disease (OR=1.34; 95% CI 1.00-1.81 symptoms were found in women. Logistic regression analysis identified associations between many forms of exposure to pesticides and increased respiratory symptoms. Occurrence of pesticide poisoning was associated with higher prevalence of asthma symptoms (OR=1.54; 95% CI: 1.04-2.58 and chronic respiratory disease symptoms (OR=1.57; 95% CI: 1.08-2.28. CONCLUSIONS: In spite of causality limitations, the study results provide evidence that farming exposure to pesticides is associated with higher prevalence of respiratory symptoms, especially when the exposure is above two days per month.

  9. 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

  10. Chronic Fatigue Syndrome (CFS): Symptoms

    Science.gov (United States)

    ... please visit this page: About CDC.gov . Chronic Fatigue Syndrome (CFS) Share Compartir Symptoms On this Page ... Symptoms What's the Clinical Course of CFS? Chronic fatigue syndrome can be misdiagnosed or overlooked because its ...

  11. 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...

  12. Pulmonary function, chronic respiratory symptoms, and health-related quality of life among adults in the United States – National Health and Nutrition Examination Survey 2007–2010

    OpenAIRE

    Wheaton, Anne G; Ford, Earl S.; Thompson, William W.; Greenlund, Kurt J.; Presley-Cantrell, Letitia R.; Croft, Janet B.

    2013-01-01

    Background We examined the association of impaired lung function and respiratory symptoms with measures of health status and health-related quality of life (HRQOL) among US adults. Methods The sample included 5139 participants aged 40–79 years in the National Health and Nutrition Examination Survey 2007–2010 who underwent spirometric testing and responded to questions about respiratory symptoms, health status, and number of physically unhealthy, mentally unhealthy, or activity limitation days...

  13. Total and Specific Immunoglobulin E and Their Relationship to Respiratory Symptoms in Quebec Children and Adolescents

    Directory of Open Access Journals (Sweden)

    Benoît Levesque

    2005-01-01

    Full Text Available BACKGROUND: Respiratory disease is a major cause of morbidity in young people. It is now recognized that atopy plays an important role in the development of chronic respiratory symptoms in children.

  14. Lung diffusion capacity in children with respiratory symptoms and untreated GERD

    OpenAIRE

    MIRIĆ, MIRJANA; Turkalj, Mirjana; Nogalo, Boro; Erceg, Damir; Perica, Marija; Plavec, Davor

    2014-01-01

    Background Gastroesophageal reflux disease (GERD) is associated with many respiratory disorders, among which, chronic cough, laryngitis, and asthma are among the most common. We investigated lung function, including gas diffusion capacity, in children with poor asthma control or chronic laryngitis with untreated GERD. Material/Methods A total of 71 children, aged 6–17 years, with chronic respiratory and other symptoms suggestive for GERD, were enrolled and divided into 2 groups: chronic laryn...

  15. 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...

  16. [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

  17. A twin study of perfume-related respiratory symptoms.

    Science.gov (United States)

    Elberling, J; Lerbaek, A; Kyvik, K O; Hjelmborg, J

    2009-11-01

    Respiratory symptoms from environmental perfume exposure are main complaints in patients with multiple chemical sensitivities and often coincide with asthma and or eczema. In this population-based twin study we estimate the heritability of respiratory symptoms related to perfume and if co-occurrences of the symptoms in asthma, atopic dermatitis, hand eczema or contact allergy are influenced by environmental or genetic factors common with these diseases. In total 4,128 twin individuals (82%) responded to a questionnaire. The heritability of respiratory symptoms related to perfume is 0.35, 95%CI 0.14-0.54. Significant associations (pperfume-related respiratory symptoms and asthma, atopic dermatitis, hand eczema or contact allergy are not attributable to shared genetic or shared environmental/familial factors, except possibly for atopic dermatitis where genetic pleiotropy with respiratory symptoms to perfume is suggested by an estimated genetic correlation of 0.39, 95%CI 0.09-0.72.

  18. A twin study of perfume-related respiratory symptoms

    DEFF Research Database (Denmark)

    Elberling, J; Lerbaek, A; Kyvik, K O;

    2009-01-01

    Respiratory symptoms from environmental perfume exposure are main complaints in patients with multiple chemical sensitivities and often coincide with asthma and or eczema. In this population-based twin study we estimate the heritability of respiratory symptoms related to perfume and if co......-occurrences of the symptoms in asthma, atopic dermatitis, hand eczema or contact allergy are influenced by environmental or genetic factors common with these diseases. In total 4,128 twin individuals (82%) responded to a questionnaire. The heritability of respiratory symptoms related to perfume is 0.35, 95%CI 0.......14-0.54. Significant associations (prespiratory symptoms and asthma, atopic dermatitis, hand eczema or contact allergy are not attributable to shared genetic or shared environmental/familial factors, except possibly for atopic dermatitis where genetic pleiotropy with respiratory symptoms...

  19. Chronic Pain: Symptoms, Diagnosis, & Treatment

    Science.gov (United States)

    ... in the treatment. Treatment With chronic pain, the goal of treatment is to reduce pain and improve ... some treatments used for chronic pain. Less invasive psychotherapy, relaxation therapies, biofeedback, and behavior modification may also ...

  20. Associations of symptoms related to isocyanate, ureaformol, and formophenolic exposures with respiratory symptoms and lung function in coal miners

    Energy Technology Data Exchange (ETDEWEB)

    Bertrand, J.P.; Simon, V.; Chau, N. [Houilleres Bassin Lorraine, Freyming Merlebach (France)

    2007-04-15

    The respiratory effects of diphenylmethane diisocyanate (MDI)-based resins and ureaformol- and formophenolic-based resins, used in coal mining, are unknown. This cross-sectional study of 354 miners evaluated respiratory health in miners with MDI-related symptoms (IS) and ureaformol/formophenolic-related symptoms (UFS). The protocol included clinical examination, chest radiograph, questionnaire on respiratory symptoms, smoking habit, job history, resin handling, and spirometry. Resin handling concerned 27.7% of the miners. IS affected 5.6%, and 1.4% also after work. UFS affected 22.6%, and 2.3% also after work. Wheezing affected 35.6%; chronic cough, expectoration, or bronchitis about 10%; dyspnea 5.4%; and asthma 2.8%. The miners with UFS had significantly more frequent chronic cough, expectoration, chronic bronchitis, dyspnea, and wheezing, whereas those with IS at and after work had markedly lower FVC, FEV1, MMEF, FEF50% and FEF25%. These findings raise the possibility of deleterious effects of exposures to MDI and ureaformol/ ormophenolic resins on respiratory health and lung function in coal miners during their working life.

  1. Respiratory symptoms in adults are related to impaired quality of life, regardless of asthma and COPD: results from the European community respiratory health survey

    Directory of Open Access Journals (Sweden)

    Bakke Per S

    2010-09-01

    symptoms in the European Community Respiratory Health Study (ECRHS varied from one percent to 35% 1. In fact, two studies have reported that more than half of the adult population suffers from one or more respiratory symptoms 45. Respiratory symptoms are important markers of the risk of having or developing disease. Respiratory symptoms have been shown to be predictors for lung function decline 678, asthma 910, and even all-cause mortality in a general population study 11. In patients with a known diagnosis of asthma or chronic obstructive pulmonary disease (COPD, respiratory symptoms are important determinants of reduced health related quality of life (HRQoL 12131415. The prevalence of respiratory symptoms exceeds the combined prevalences of asthma and COPD, and both asthma and COPD are frequently undiagnosed diseases 161718. Thus, the high prevalence of respipratory symptoms may mirror undiagnosed and untreated disease. The common occurrence of respiratory symptoms calls for attention to how these symptoms affect health also in subjects with no diagnosis of obstructive airways disease. Impaired HRQoL in the presence of respiratory symptoms have been found in two population-based studies 619, but no study of respiratory sypmtoms and HRQoL have separate analyses for subjects with and without asthma and COPD, and no study provide information about extensive objective measurements of respiratory health. The ECRHS is a randomly sampled, multi-cultural, population based cohort study. The ECRHS included measurements of atopy, bronchial hyperresponsiveness (BHR, and lung function, and offers a unique opportunity to investigate how respiratory symptoms affect HRQoL among subjects both with and without obstructive lung disease. In the present paper we aimed to: 1 Describe the relationship between respiratory symptoms and HRQoL in an international adult general population and: 2 To assess whether this relationship varied with presence of asthma and/or COPD, or presence of objective

  2. Elevated exhaled nitric oxide in anaphylaxis with respiratory symptoms

    Directory of Open Access Journals (Sweden)

    Yoichi Nakamura

    2015-10-01

    Conclusions: Elevation of FeNO was related to respiratory symptoms observed in anaphylactic patients without asthma. Although the mechanism of increased FeNO level is unclear, its usefulness for diagnosis of anaphylaxis must be examined in prospective studies.

  3. Management of respiratory symptoms in ALS.

    LENUS (Irish Health Repository)

    Hardiman, Orla

    2012-02-01

    Respiratory insufficiency is a frequent feature of ALS and is present in almost all cases at some stage of the illness. It is the commonest cause of death in ALS. FVC is used as important endpoint in many clinical trials, and in decision-making events for patients with ALS, although there are limitations to its predictive utility. There are multiple causes of respiratory muscle failure, all of which act to produce a progressive decline in pulmonary function. Diaphragmatic fatigue and weakness, coupled with respiratory muscle weakness, lead to reduced lung compliance and atelectasis. Increased secretions increase the risk of aspiration pneumonia, which further compromises respiratory function. Bulbar dysfunction can lead to nutritional deficiency, which in turn increases the fatigue of respiratory muscles. Early recognition of respiratory decline and symptomatic intervention, including non-invasive ventilation can significantly enhance both quality of life and life expectancy in ALS. Patients with respiratory failure should be advised to consider an advance directive to avoid emergency mechanical ventilation.

  4. Management of respiratory symptoms in ALS.

    LENUS (Irish Health Repository)

    Hardiman, Orla

    2011-03-01

    Respiratory insufficiency is a frequent feature of ALS and is present in almost all cases at some stage of the illness. It is the commonest cause of death in ALS. FVC is used as important endpoint in many clinical trials, and in decision-making events for patients with ALS, although there are limitations to its predictive utility. There are multiple causes of respiratory muscle failure, all of which act to produce a progressive decline in pulmonary function. Diaphragmatic fatigue and weakness, coupled with respiratory muscle weakness, lead to reduced lung compliance and atelectasis. Increased secretions increase the risk of aspiration pneumonia, which further compromises respiratory function. Bulbar dysfunction can lead to nutritional deficiency, which in turn increases the fatigue of respiratory muscles. Early recognition of respiratory decline and symptomatic intervention, including non-invasive ventilation can significantly enhance both quality of life and life expectancy in ALS. Patients with respiratory failure should be advised to consider an advance directive to avoid emergency mechanical ventilation.

  5. Impact of chronic respiratory symptoms in a rural area of sub-Saharan Africa : an in-depth qualitative study in the Masindi district of Uganda

    NARCIS (Netherlands)

    van Gemert, Frederik; Chavannes, Niels; Nabadda, Nahid; Luzige, Simon; Kirenga, Bruce; Eggermont, Celeste; de Jong, Corina; van der Molen, Thys

    2013-01-01

    Background: Chronic obstructive pulmonary disease (COPD), once regarded as a disease of developed countries, is now recognised as a common disease in low- and middle-income countries. No studies have been performed to examine how the community in resource-poor settings of a rural area in sub-Saharan

  6. Work-Related Respiratory Symptoms and Airway Disease in Hairdressers

    Directory of Open Access Journals (Sweden)

    K Gourgoulianis

    2013-04-01

    Full Text Available Background: Hairdressers are occupationally exposed to a number of agents in their workplace that result in respiratory symptoms and changes in pulmonary function.Objective: To evaluate associations between occupational exposure and respiratory function and reported symptoms in a group of hairdressers compared to a control group.Methods: A questionnaire on respiratory symptoms and workplace characteristics was completed by 94 hairdressers and 39 age- and sex-matched controls. Spirometry and exhaled nitric oxide (FeNO measurements were also performed.Results: Hairdressers reported more severe dyspnea (p=0.03 and eye (p=0.001 and throat (p=0.007 irritation, compared to the control group, at the workplace; no differences were noted at home. Lower FEV1/FVC (pConclusion: Worsening of symptoms and pulmonary function at workplace, and alleviating the symptoms at home, indicate that they may be related to occupational exposure.

  7. Prevalence of respiratory symptoms and spirometric values in aluminium potroom workers.

    Science.gov (United States)

    Kezunović, Ljiljana Cvejanov

    2008-06-01

    The goal of this study was to examine the prevalence of chronic respiratory symptoms in potroom workers and to compare these results with changes in spirometric parameters. A modified questionnaire on respiratory symptoms from the British Medical Research Council was used to take the medical history data about respiratory symptoms. Spirometric parameters were determined on the same day (as a part of regular checkups) using the Jaeger spirometer. The study included 215 potroom workers from the aluminium factory in Podgorica, Montenegro. All subjects were men, but they differed in age and duration of work. The group used for comparison consisted of 81 unemployed male applicants for jobs in the factory who had never been exposed to this kind of air pollution before. Potroom workers mostly complained of breathlessness associated with the workplace (56.7 %) or weather changes (rain, cold wind, and humidity) (41.9%) and of dyspnoea when climbing stairs (51.2 %), but only 22.3 % reported using medication to treat these episodes. Most workers reported to have been smoking at the time of the study (62.4 %). Spirometric data showed only insignificant variations compared to the expected values (CECA standards). Chronic obstructive pulmonary disease (COPD), characterised by FEV1/VC % <88 % was found in only 17 (7.9 %) potroom workers, while asthma was identified in 9 (4.2 %). Although the prevalence of chronic respiratory symptoms reported by the examined potroom workers was quite high at the group level, they were not associated with ventilatory impairments. PMID:18573745

  8. Decreased respiratory symptoms in cannabis users who vaporize

    Directory of Open Access Journals (Sweden)

    Barnwell Sara

    2007-04-01

    Full Text Available Abstract Cannabis smoking can create respiratory problems. Vaporizers heat cannabis to release active cannabinoids, but remain cool enough to avoid the smoke and toxins associated with combustion. Vaporized cannabis should create fewer respiratory symptoms than smoked cannabis. We examined self-reported respiratory symptoms in participants who ranged in cigarette and cannabis use. Data from a large Internet sample revealed that the use of a vaporizer predicted fewer respiratory symptoms even when age, sex, cigarette smoking, and amount of cannabis used were taken into account. Age, sex, cigarettes, and amount of cannabis also had significant effects. The number of cigarettes smoked and amount of cannabis used interacted to create worse respiratory problems. A significant interaction revealed that the impact of a vaporizer was larger as the amount of cannabis used increased. These data suggest that the safety of cannabis can increase with the use of a vaporizer. Regular users of joints, blunts, pipes, and water pipes might decrease respiratory symptoms by switching to a vaporizer

  9. Obsessive and compulsive symptoms in chronic schizophrenia.

    Science.gov (United States)

    Berman, I; Kalinowski, A; Berman, S M; Lengua, J; Green, A I

    1995-01-01

    The goals of the study were to determine the prevalence of obsessive or compulsive (OC) symptoms among chronic schizophrenic patients, and to elucidate the level of function and course of illness in chronic schizophrenic patients with and without such symptoms. Therapists of 102 patients with DSM-III-R diagnoses of chronic schizophrenia reported on their patients' OC symptoms, level of function, and course of illness. Twenty-five percent of the chronic schizophrenic patients presented with significant OC symptoms. The OC schizophrenics had significantly earlier onsets of their illnesses, had spent more time in the hospital in the previous 5 years, and were judged by their therapists to have a lower level of capacity for age-appropriate function. In addition, such patients had been less often employed and less often married, and were more dependent on others. The poorer prognosis for schizophrenic patients with OC symptoms than for those without these symptoms suggests the need for new therapeutic strategies for such patients. PMID:7705089

  10. Asthma and respiratory symptoms among hairdressers in Denmark

    DEFF Research Database (Denmark)

    Lysdal, Susan Hovmand; Mosbech, Holger; Johansen, Jeanne Duus;

    2014-01-01

    BACKGROUND: Hairdressers are at risk of developing occupational respiratory disorders due to persulfates and other hairdressing chemicals. METHODS: A register based questionnaire study comprising 7,840 graduates from hairdressing vocational schools was conducted. The postal questionnaire concerned....... CONCLUSIONS: Asthma and especially respiratory symptoms were commonly reported by hairdressers, but rarely reported as an occupational disease. Local exhaust ventilation was inconsistently used. Our results underline the need for improved measures to ascertain and prevent occupational asthma in hairdressers....

  11. Lung function and respiratory symptoms in pig farmers.

    OpenAIRE

    Bongers, P; Houthuijs, D; Remijn, B; Brouwer, R.; Biersteker, K

    1987-01-01

    In a pilot study to investigate the health effects of swine confinement work on the respiratory tract pulmonary function tests and a questionnaire for respiratory symptoms were used. Complete data, including qualitative exposure information, were gathered for 132 owners of fattening, breeding, or closed pig farms. All measured pulmonary function values, except the FVC, were on average lower than the reference values of the European Committee for Coal and Steel. There were no significant assoc...

  12. Respiratory symptoms and functions in barn workers

    OpenAIRE

    Ege Gulec Balbay; Emine Banu Cakiroglu; Peri Arbak; Öner Balbay; Fatma Avcıoğlu; Abdullah Belada

    2014-01-01

    Introduction and aim. The presented study was undertaken to investigate the respiratory health problems in family barns with one or more cows and at least one family member working in the barn. Methods. 150 workers (128 female, 22 male) from 4 villages of Yığılca district near the city of Düzce in north-west Turkey were enrolled in this study between October – December 2011. An Occupational and Environmental Chest Diseases questionnaire developed by the American Thoracic Society, pulmonary...

  13. Bronchodilator responsiveness and reported respiratory symptoms in an adult population.

    Directory of Open Access Journals (Sweden)

    Wan C Tan

    Full Text Available BACKGROUND: The relationship between patient-reported symptoms and objective measures of lung function is poorly understood. AIM: To determine the association between responsiveness to bronchodilator and respiratory symptoms in random population samples. METHODS: 4669 people aged 40 years and older from 8 sites in Canada completed interviewer-administered respiratory questionnaires and performed spirometry before and after administration of 200 ug of inhaled salbutamol. The effect of anthropometric variables, smoking exposure and doctor-diagnosed asthma (DDA on bronchodilator responsiveness in forced expiratory volume in 1 second (FEV1 and in forced vital capacity (FVC were evaluated. Multiple logistic regression was used to test for association between quintiles of increasing changes in FEV1 and in FVC after bronchodilator and several respiratory symptoms. RESULTS: Determinants of bronchodilator change in FEV1 and FVC included age, DDA, smoking, respiratory drug use and female gender [p<0.005 to p<0.0001 ]. In subjects without doctor-diagnosed asthma or COPD, bronchodilator response in FEV1 was associated with wheezing [p for trend<0.0001], while bronchodilator response for FVC was associated with breathlessness. [p for trend <0.0001]. CONCLUSIONS: Bronchodilator responsiveness in FEV1 or FVC are associated with different respiratory symptoms in the community. Both flow and volume bronchodilator responses are useful parameters which together can be predictive of both wheezing and breathlessness in the general population.

  14. Persistent Respiratory Symptoms following Prolonged Capsaicin Exposure

    Directory of Open Access Journals (Sweden)

    K Nugent

    2013-10-01

    Full Text Available Capsaicin causes direct irritation of the eyes, mucous membranes, and respiratory tract. It is used in self-defense, in crowd control, and as a less lethal weapon in police work. Controlled trials suggest that capsaicin has minimal serious acute effects. Herein, we report a woman who had a 20-minute exposure to capsaicin during a jail riot. She subsequently developed episodic dyspnea and cough, and increased sensitivity to scents, perfumes, and cigarette smoke. She has not had wheezes on physical examination or abnormal pulmonary function tests. Her response to inhaled steroids and long-acting beta-agonists has been incomplete. She appears to have developed airway sensory hyperreactivity syndrome after the inhalation of capsaicin, which likely injured sensory nerves and/or caused persistent neurogenic inflammation.

  15. Occupation and three-year incidence of respiratory symptoms and lung function decline: the ARIC Study

    Directory of Open Access Journals (Sweden)

    Mirabelli Maria C

    2012-03-01

    Full Text Available Abstract Background Specific occupations are associated with adverse respiratory health. Inhalation exposures encountered in these jobs may place workers at risk of new-onset respiratory disease. Methods We analyzed data from 8,967 participants from the Atherosclerosis Risk in Communities (ARIC study, a longitudinal cohort study. Participants included in this analysis were free of chronic cough and phlegm, wheezing, asthma, chronic bronchitis, emphysema, and other chronic lung conditions at the baseline examination, when they were aged 45-64 years. Using data collected in the baseline and first follow-up examination, we evaluated associations between occupation and the three-year incidence of cough, phlegm, wheezing, and airway obstruction and changes in forced expiratory volume in one second (FEV1 and forced vital capacity (FVC measured by spirometry. All associations were adjusted for age, cigarettes per day, race, smoking status, and study center. Results During the approximately three-year follow-up, the percentage of participants developing chronic cough was 3%; chronic phlegm, 3%; wheezing, 3%; and airway obstruction, defined as FEV1 1/FVC 1 and FVC were 56 mL and 66 mL, respectively, among men and 40 mL and 52 mL, respectively, among women. Relative to a referent category of managerial and administrative support occupations, elevated risks of new-onset chronic cough and chronic phlegm were observed for mechanics and repairers (chronic cough: RR: 1.81, 95% CI: 1.02, 3.21; chronic phlegm: RR: 2.10, 95% CI: 1.23, 3.57 and cleaning and building service workers (chronic cough: RR: 1.85, 95% CI: 1.01, 3.37; chronic phlegm: RR: 2.28, 95% CI: 1.27, 4.08. Despite the elevated risk of new-onset symptoms, employment in cleaning and building services was associated with attenuated lung function decline, particularly among men, who averaged annual declines in FEV1 and FVC of 14 mL and 23 mL, respectively, less than the declines observed in the

  16. Pets, allergy and respiratory symptoms in children living in a desert country.

    Science.gov (United States)

    Bener, A; Galadari, I; Naser, K A

    1995-06-01

    The aim of this paper was to study the effect of pets and other domestic animals effect on allergic respiratory symptoms among United Arab Emirates primary school children. A cross-sectional survey of 2200 school children living in both urban and rural areas was conducted using self-administered questionnaires between November 1993 and June 1994. The age range of the children studied was 6-12 years, with a mean of 9.23 and standard deviation of 2.14 years; 51% were girls and 49% were boys. Pet ownership was defined by the presence of birds, cats, camels, dogs, goats, poultry and rabbits in the home. One thousand and thirty-six (1036/2090 = 49.6%) of the 2090 families studied had at least one animal at home. However, respiratory symptoms, pet allergy, chronic cough, chronic wheeze, breathlessness or chest tightness, doctor-diagnosed asthma, rhinitis and eczema was reported by 633 families (30.3%) from 2090 studied families. The highest prevalence of reported respiratory allergy and symptoms was found in children who had pets in the past and currently. The lowest prevalence of reported respiratory allergy and symptoms was found in children who never had pets in their lives. Past pets ownership was generally associated with a higher prevalence of pets allergy and respiratory symptoms. No less than 218 (10.4%) reported removing pets in the past because of an allergy or other health problems in the child or in other family members. The risk of having pet allergy in children with animals was found to be twice than that of children without (RR: 2.13; 95% CI: 1.53-2.97; p < 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7626193

  17. Effects of air pollution related respiratory symptoms in school children in industrial areas Rayong, Thailand

    Directory of Open Access Journals (Sweden)

    Paradee Asa

    2016-01-01

    Full Text Available The chronic effects of air pollution in school children living near industrial sites were investigated. The respiratory symptoms of 806 school children aged 9-12 years were examined by the American Thoracic Society's Division of Lung Diseases (ATS-DLD-78-C questionnaire during February- August 2013. The selected elementary schools in this survey was based on the distance from Map Ta Phut Industrial Estate, area A within 1 km., area B 5 km. and area C 10 km. Logistic regression techniques were used to assess the association between prevalence of respiratory symptoms and independent variables. The average 24 hrs PM10 and VOCs concentrations from 2011-2014 in area A were significantly higher than in area C (p < 0.05. Relatively, the prevalence of respiratory symptoms in area A were high with odds ratios (OR = 3.41, (95% confidence intervals (CI = 1.70-6.85 and in area B with OR = 1.36, (95% CI = 0.54-3.45, in comparison to area C. The prevalent of non-specific respiratory diseases (NSRD and Persistent Cough and Phlegm (PCP in boy student were higher than girls students with OR=2.17, (95%CI=1.33-3.53, whereas those factors such as age, residential years, home size, parental smoking habits, use of air conditioners and domestic pets were not associated. Exposure to particulate matter and volatile organic compounds arising from Industrial sites was associated with worse respiratory impairments in children.

  18. European study protocol: `Effect of short-term changes in urban air pollution on the respiratory health of children with chronic respiratory symptoms. The PEACE project, Pollution Effects on Asthmatic Children in Europe

    Energy Technology Data Exchange (ETDEWEB)

    Roemer, W.; Hoek, G.; Brunekreef, B. [Wageningen Univ. (Netherlands). Dept. of Epidemiology and Public Health] [and others

    1995-12-31

    Over the last decades, concentrations of air pollution components such as SO{sub 2} and airborne, coarse particulates have decreased in many areas in Europe. This decrease can be ascribed to emission abatement measures and changes in energy production for industrial processes and space heating. Levels of other pollutants such as NO{sub 2} have increased during the same period, mostly due to higher intensity of motor vehicle traffic. Older epidemiologic studies on health effects of air pollution used indicator pollutants such as SO{sub 2}, Total Suspended Particulate matter (TSP) and Black Smoke at extremely high levels. More recent studies using the same and other indicators such as PM10 (particles with a median aerodynamic diameter of 10 {mu}m) have shown effects of air pollution on mortality and morbidity at lower levels, even sometimes lower than current WHO air quality guidelines for Europe. These findings suggest that due to the changing composition of air pollution, effects of air pollution can be seen below levels of exposure which were thought to be safe. Another reason is that the recent studies are conducted at levels which were hard to find in earlier days. Therefore new, quantitative data are needed to evaluate the current guidelines and standards. In order to achieve this, standardization of methodology as well as the execution of epidemiologic studies using such standardized methodology is needed. In the framework of the ENVIRONMENT Research Programme of the Commission of the European Communities, a collaborative study was funded that sought to develop a standardized methodology for epidemiologic studies of effects short-term changes in air pollution on the respiratory system

  19. Respiratory symptoms among farmers in the vicinity of a north Indian city

    Directory of Open Access Journals (Sweden)

    Behera D

    2005-01-01

    Full Text Available Exposure to various types of farming occupation is associated with a number of respiratory problems which are both immunologic and non-immunologic in orgin. This study was undertaken to determine the prevalence of various respiratory symptoms and assess pulmonary function among farmers around the city of Chandigarh. An attempt was also made to identify the types of farming that may be associated with these symptoms. A house-to-house survey was carried out in seven villages around Chandigarh with the help of a questionnaire that was used in our earlier surveys. Lung function tests were carried out using a portable spirometer. Out of the 486 farmers included in the study, 106(21.8% were symptomatic: chronic bronchitis (n=34, cough (n=38, bronchial asthma (n=13, post nasal drip (n=9, chest tightness (n=8 and dyspnea (n=4. The respiratory symptoms were more common among non-smokers (55.6% than smokers (44.3%. Combined type of farming work was associated most often with respiratory symptoms followed by grain cutting. Pulmonary function parameters had lower values in smokers than in non-smokers and in symptomatic than in asymptomatic sybjects.

  20. Chronic symptoms and pulmonary dysfunction in post-tuberculosis Brazilian patients

    Directory of Open Access Journals (Sweden)

    Simone de Sousa Elias Nihues

    2015-10-01

    Full Text Available ABSTRACTBACKGROUND: Questionnaire and spirometry were applied to post-tuberculosis indigenous and non-indigenous individuals from Dourados, Brazil, to investigate the prevalence of chronic respiratory symptoms and pulmonary dysfunction.METHODS:This was a cross-sectional study in cured tuberculosis individuals as reported in the National System on Reportable Diseases (SINAN from 2002 to 2012.RESULTS:One hundred and twenty individuals were included in the study and the prevalence of chronic respiratory symptoms was 45% (95% CI, 34-59%. Respiratory symptoms included cough (28%, sputum (23%, wheezing (22% and dyspnea (8%. These symptoms were associated with alcoholism, AOR: 3.1 (1.2-8.4; less than 4 years of schooling, AOR: 5.0 (1.4-17.7; and previous pulmonary diseases, AOR: 5.4 (1.7-17.3. Forty-one percent (95% CI, 29-56 had pulmonary disorders, of which the most prevalent were obstructive disorders (49%, followed by obstructive disorder with reduced forced vital capacity disorders (46% and restrictive disorders (5%. The lifestyle difference could not explain differences in chronic symptoms and/or the prevalence of pulmonary dysfunction.CONCLUSION:The high prevalence of chronic respiratory symptoms and pulmonary dysfunction in post-tuberculosis patients indicates a need for further interventions to reduce social vulnerability of patients successfully treated for tuberculosis.

  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. 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)

  3. Chronic candidiasis - pathogenesis, symptoms, diagnosis and treatment

    Directory of Open Access Journals (Sweden)

    Klajn-Laslo Marija

    2009-01-01

    Full Text Available The yeast named Candida normally colonizes the gut and vagina without causing any sign of its presence. It is a commensal and opportune fungus but in certain conditions it turns to be pathogenic, causing chronic disturbances in any part of the body. The pathogenesis is complex, signs and symptoms are non-specific. The colonisation is difficult to distinguish from invasive disease. The current diagnostic methods do not always allow a definitive diagnosis to be made. Treatment is complex, individual and no protocol can be created. The author tries to give an overview of the Candida related problem.

  4. Chronic symptoms and pulmonary dysfunction in post-tuberculosis Brazilian patients

    OpenAIRE

    Simone de Sousa Elias Nihues; Eliane Viana Mancuzo; Nara Sulmonetti; Flávia Patussi Correia Sacchi; Vanessa de Souza Viana; Eduardo Martins Netto; Silvana Spindola de Miranda; Julio Croda

    2015-01-01

    ABSTRACTBACKGROUND: Questionnaire and spirometry were applied to post-tuberculosis indigenous and non-indigenous individuals from Dourados, Brazil, to investigate the prevalence of chronic respiratory symptoms and pulmonary dysfunction.METHODS:This was a cross-sectional study in cured tuberculosis individuals as reported in the National System on Reportable Diseases (SINAN) from 2002 to 2012.RESULTS:One hundred and twenty individuals were included in the study and the prevalence of chronic re...

  5. The association between methacholine challenge test and respiratory symptoms: a study on 146 patients

    Directory of Open Access Journals (Sweden)

    Paknejad O

    2011-02-01

    Full Text Available "nBackground: Asthma is a life-threatening disease that can cause death due to bronchospasm. In addition to clinical symptoms such as wheezing, acute paroxysmal dyspnea, chronic cough after exposure to cold air or cough after exercise, spirometry is also necessary for the diagnosis of asthma. The association between respiratory symptoms and a positive methacholine challenge test (MCT is still controversial. The aim of this study was to determine the association between methacholine test results and respiratory symptoms and allergy."n "nMethods: One hundred and forty-six patients with respiratory symptoms and normal baseline pulmonary function tests were enrolled in this cross-sectional study. The participants were divided into two groups according to their positive or negative response to MCT. The association between MCT and the clinical symptoms and allergy was later evaluated statistically."n "nResults: Out of 146 participants of the study 59 (40.4% were female and 87 (59.6% were male. The mean age of the participants was 33.8±13.8 years. Sixty-one patients (41.8% had positive results for the test. There was an association between a history of allergy, wheezing and age with positive MCT results. The other clinical signs had no association with the test."n "nConclusion: Methacholine challenge test is the best diagnostic test for ruling out asthma in patients with normal pulmonary function tests in whom we cannot definitely rule out asthma based solely on clinical symptoms. Nevertheless, in adults with a history of allergy, wheezing and also in patients below 30, the probability for a positive MCT is high.

  6. The World Trade Center Residents’ Respiratory Health Study: New-Onset Respiratory Symptoms and Pulmonary Function

    OpenAIRE

    Reibman, Joan; Lin, Shao; Hwang, Syni-An A.; Gulati, Mridu; Bowers, James A.; Rogers, Linda; Berger, Kenneth I.; Hoerning, Anne; Gomez, Marta; Fitzgerald, Edward F.

    2004-01-01

    The destruction of the World Trade Center (WTC) on 11 September 2001 in New York City resulted in the massive release of pulverized dust and combustion products. The dust and smoke settled in the surrounding area, which encompassed a large residential community. We hypothesized that previously normal residents in the community surrounding the former WTC would have an increased incidence of persistent respiratory symptoms and abnormalities in screening spirometry. A hybrid cross-sectional and ...

  7. Pantoea agglomerans in Immunodeficient Patients with Different Respiratory Symptoms

    Directory of Open Access Journals (Sweden)

    Erika Odilia Flores Popoca

    2012-01-01

    Full Text Available The aim of this paper was to determine in 32 patients from 4 different Mexican hospitals the frequency of opportunistic bacteria in the 2010 to 2011 time period. The patients were divided in 4 groups. Group 1 included 21 HIV positive patients with acute respiratory syndrome. Four HIV positive patients with tuberculosis symptoms were included in Group 2; two patients with tuberculosis symptoms and one asymptomatic person formed Group 3. Reference Group 4 included 4 patients from whom 4 strains of Mycobacterium spp. had been reported. The strains were isolated and identified by 16S rRNA gene amplification, API 20E and 50CH, biochemical test, and antibiotic sensitivity. The strains found were 10 Pantoea agglomerans, 6 Mycobacterium spp., 6 Pseudomonas spp. and 10 strains of normal floral species: Thermoactinomycetes bacterium (1, Enterococcus faecium (2, Bacillus licheniformis (1, Lactobacillus rhamnosus (2, Streptococcus oralis (2, Streptococcus anginosus (1, and Enterobacter hormaechei (1.

  8. 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)

  9. 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...

  10. Asthma, allergy, and respiratory symptoms in centenarians living in Poland.

    Science.gov (United States)

    Mossakowska, M; Pawlinska-Chmara, R; Broczek, K M

    2008-12-01

    According to National Census, there were 1541 people over the age of 100 years (centenarians) in Poland, in 2002, including 1215 females and 326 males. The aim of the present study was to assess the prevalence of asthma, allergy, and respiratory symptoms in centenarians included in the Polish Centenarians Program, POLSTU 2001, conducted between 2001 and 2004. The study group consisted of 301 subjects including 258 females and 43 males. Research data were gathered in a questionnaire designed exclusively for the study, completed by the interviewer during meetings with the subjects and their families. According to the medical history reported by the subjects, 10 persons (3.3%) suffered from asthma and 41 (13.6%) from allergy. There were no subjects with childhood onset asthma. Allergy to food and medicinal products was the most prevalent. One in four centenarians reported dyspnea and one in eight complained of cough. When analyzed in relation to gender, cough was more prevalent in males, which might have been related to cigarette smoking. Respiratory disorders are frequent in elderly populations, but symptoms may be underreported, especially in the situation of coexisting medical problems. Moreover, it might be difficult to perform full diagnostic procedures in the very elderly due to disability, cognitive impairment, and technical problems. Thus, medical care for the aged should be based on thorough medical evaluation supported by the medical history and reliable information on physician-diagnosed diseases.

  11. Respiratory symptoms, sensitization, and exposure-response relationships in spray painters exposed to isocyanates

    NARCIS (Netherlands)

    Pronk, A.; Preller, L.; Raulf-Heimsoth, M.; Jonkers, I.C.L.; Lammers, J.-W.; Wouters, I.M.; Doekes, G.; Wisnewski, A.V.; Heederik, D.

    2007-01-01

    Rationale: Associations between oligomeric isocyanate exposure, sensitization, and respiratory disease have received little attention, despite the extensive use of isocyanate oligomers. Objectives: To investigate exposure-response relationships of respiratory symptoms and sensitization in a large po

  12. Long-term effects of welding fumes upon respiratory symptoms and pulmonary function.

    Science.gov (United States)

    Akbarkhanzadeh, F

    1980-05-01

    To evaluate the long-term influence of welding fumes and of cigarette smoke on the function of the bronchopulmonary system a comparative study of spirometric measurements in 209 welders and 109 non-welder controls was performed in a shipyard. The two groups were matched for age, height, smoking habits, residence and social class. Fifty-one percent of the welders had one or more of the respiratory symptoms, while only 26% of the controls had any of the symptoms. Chronic bronchitis was found to be confined to welders who smoked or had smoked. The welders appeared to show significantly increased impairment of lung function and, with advancing years, a deterioration in lung function greater than that of the controls, but, in general, they did not show serious pulmonary insufficiency.

  13. Increased detection of respiratory syncytial virus, influenza viruses, parainfluenza viruses, and adenoviruses with real-time PCR in samples from patients with respiratory symptoms

    NARCIS (Netherlands)

    van de Pol, Alma C.; van Loon, Anton M.; Wolfs, Tom F. W.; Jansen, Nicolaas J. G.; Nijhuis, Monique; Breteler, Els Klein; Schuurman, Rob; Rossen, John W. A.

    2007-01-01

    Respiratory samples (n = 267) from hospitalized patients with respiratory symptoms were tested by real-time PCR, viral culture, and direct immunofluorescence for respiratory syncytial virus, influenza virus, parainfluenza viruses, and adenoviruses. Compared with conventional diagnostic tests, real-t

  14. [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.

  15. Quantitative computed tomography measures of emphysema and airway wall thickness are related to respiratory symptoms

    DEFF Research Database (Denmark)

    Grydeland, Thomas B; Dirksen, Asger; Coxson, Harvey O;

    2010-01-01

    There is limited knowledge about the relationship between respiratory symptoms and quantitative high-resolution computed tomography measures of emphysema and airway wall thickness.......There is limited knowledge about the relationship between respiratory symptoms and quantitative high-resolution computed tomography measures of emphysema and airway wall thickness....

  16. Association between occupational stress and respiratory symptoms among lecturers in Universiti Putra Malaysia.

    Science.gov (United States)

    Nur Aqilah, Mohmed Yusof; Juliana, Jalaludin

    2012-11-01

    There was considerable evidence that a subject's psychological status may influence respiratory sensations and that some subjects may experience respiratory symptoms regardless of the presence of a respiratory disease. The objective of this study was to determine the association between occupational stress and respiratory symptoms among lecturers. This cross sectional study was conducted in Universiti Putra Malaysia, involved 61 lecturers from various faculties. Job Content Questionnaire (JCQ) and questionnaires based on American Thoracic Society were used to collect the data on socio-demography, stress level and respiratory symptoms. High level of occupational stress (high strain) was determined among 16 of the respondents (26.2%). Breathlessness was the common symptom experienced by the respondents. Female lecturers were significantly experienced high stress level compared to male (p=0.035). They were also significantly having more breathlessness symptom compared to male lecturer (p=0.011). Study highlighted in study population, gender plays a significant role that influenced level of occupational stress and also gender has role in resulting occupational stress level and respiratory symptoms. There was no significant association between occupational stress and respiratory symptoms. It can be concluded that this group of lecturers of Universiti Putra Malaysia did not experienced high occupational stress level. Occupational stress level was not statistically significantly associated with all respiratory symptoms being studied. PMID:23121752

  17. The adult incidence of asthma and respiratory symptoms by passive smoking in utero or in childhood

    Directory of Open Access Journals (Sweden)

    T. Duelien

    2006-12-01

    Full Text Available The effects of pre- or postnatal passive smoking on the adult incidence of asthma have not been reported previously. Between 1985 and 1996/1997, we conducted an 11-year community cohort study on the incidence of asthma and respiratory symptoms in Western Norway. The cohort included 3,786 subjects aged 15 to 70 years, of which 2,819 were responders at both baseline and follow-up. The incidence of asthma and five respiratory symptoms by self-reported exposure to maternal smoking in utero and in childhood, as well as smoking by other household members in childhood, was examined. After adjustment for sex, age, education, hay fever, personal smoking, and occupational exposure, maternal smoking was associated with asthma, phlegm cough, chronic cough, dyspnoea grade 2, attacks of dyspnoea, and wheezing, with odds ratios (95% confidence intervals [CI] of 3.0 (1.6, 5.6, 1.7 (1.1, 2.6, 1.9 (1.2, 3.0, 1.9 (1.2, 3.0, 2.0 (1.3, 3.0, and 1.4 (0.9, 2.2, respectively. The adjusted attributable fractions (95% CI of the adult incidence of asthma were 17.3% (5.2, 27.9 caused by maternal smoking and 9.3% (23.2, 33.2 caused by smoking by other household members. Exposure to pre- and postnatal smoking carries a substantial risk for developing adult asthma and respiratory symptoms.

  18. 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.

  19. Respiratory symptoms and sensitization in bread and cake bakers.

    Science.gov (United States)

    Smith, T A; Smith, P W

    1998-07-01

    This purpose of this study was to examine the relationship between exposure to wheat flour, soya flour and fungal amylase and the development of work-related symptoms and sensitization in bread and cake bakery employees who have regular exposure to these substances. The study populations consisted of 394 bread bakery workers and 77 cake bakery workers whose normal jobs involved the sieving, weighing and mixing of ingredients. The groups were interviewed with the aim of identifying the prevalence, nature and pattern of any work-related respiratory symptoms. They were also skin-prick tested against the common bakery sensitizing agents, i.e., wheat flour, soya flour, rice flour and fungal amylase. The results of personal sampling for sieving, weighing and mixing operations at the bakeries from which the study groups were taken were collated in order to determine typical exposures to total inhalable dust from the ingredients, expressed as 8 hour time-weighted average exposures. Data from the health surveillance and collated dust measurements were compared with the aim of establishing an exposure-response relationship for sensitization. The prevalence of work-related symptoms in bread bakery and cake bakery ingredient handlers was 20.4% and 10.4% respectively. However, in a large proportion of those reporting symptoms in connection with work, the symptoms were intermittent and of short duration. It is considered that the aetiology of such symptoms is likely to be due to a non-specific irritant effect of high total dust levels, rather than allergy. None of the cake bakers and only 3.1% of the bread bakers had symptoms which were thought to be due to allergy to baking ingredients. Using skin-prick testing as a marker of sensitization, the prevalence of positive tests to wheat flour was 6% for the bread bakers and 3% for the cake bakers. Comparable prevalences for soya flour were 7% and 1% respectively. However, the prevalence of positive skin-prick tests to fungal amylase

  20. Characteristics and predictors of readiness to quit among emergency medical patients presenting with respiratory symptoms

    OpenAIRE

    Bock, Beth C; Jennings, Ernestine; Becker, Bruce M.; Partridge, Robert; Niaura, Raymond S

    2011-01-01

    Purpose To examine behavioral factors that lead patients to consider quitting smoking and features associated with readiness to quit among adults who are seeking treatment in the emergency department (ED) for respiratory symptoms. Methods A toal of 665 adult smokers seeking treatment in an ED for respiratory symptoms and respiratory illness answered survey questions during the ED visit. Results Patients self-reported "readiness to quit" was broadly distributed among this patient population. P...

  1. 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.

  2. 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.

  3. Occupational exposure to particulate matter and respiratory symptoms in Portuguese swine barn workers.

    Science.gov (United States)

    Viegas, S; Mateus, V; Almeida-Silva, M; Carolino, E; Viegas, C

    2013-01-01

    Certain environmental conditions in animal and plant production have been associated with increased frequency in respiratory illnesses, including asthma, chronic bronchitis, and hypersensitivity pneumonitis, in farmers occupationally exposed in swine production. The aim of this study was to characterize particulate matter (PM) contamination in seven Portuguese swine farms and determine the existence of clinical symptoms associated with asthma and other allergy diseases, utilizing the European Community Respiratory Health Survey questionnaire. Environmental assessments were performed with portable direct-reading equipment, and PM contamination including five different sizes (PM0.5, PM1.0, PM2.5, PM5.0, PM10) was determined. The distribution of particle size showed the same trend in all swine farms, with high concentrations of particles with PM5 and PM10. Results from the questionnaire indicated a trend such that subjects with diagnosis of asthma were exposed to higher concentrations of PM with larger size (PM2.5, PM5, and PM10) while subjects with sneezing, runny nose, or stuffy nose without a cold or flu were exposed to higher concentrations of PM with smaller size (PM0.5 and PM1). Data indicate that inhalation of PM in swine farm workers is associated with increased frequency of respiratory illnesses. PMID:24168036

  4. Prevalence and risk factors of respiratory symptoms among home-based garment workers in Bangkok, Thailand.

    Science.gov (United States)

    Chumchai, Pornlert; Silapasuwan, Pimpan; Wiwatwongkasem, Chukiat; Arphorn, Sara; Suwan-Ampai, Plernpit

    2015-05-01

    This study aimed to determine the prevalence and risk factors associated with respiratory symptoms. A cross-sectional study with random sampling method was employed and 300 home-based garment workers (HBGWs) were recruited. Risk factors, including personal factors; knowledge, health preventive behaviors, and skill of self-health surveillance, working condition, and respiratory symptoms were assessed. Data were collected using self-reported questionnaires. Prevalence of respiratory symptom was 22.3%. Majority of participants were female (78%). Mean age and working experience were 37.38 years (SD = 10.70) and 13.58 years (SD = 8.71), respectively. Allergic respiratory symptoms (odds ratio [OR] = 16.5; 95% confidence interval [CI] = 8.61-31.7) and garment dust exposure (OR = 12.3; 95% CI = 6.49-23.3) were significantly associated with respiratory symptoms (P < .001). Logistic regression analysis indicated history of allergic predicted the respiratory symptoms (OR = 12.96; 95% CI = 4.24-39.55). HBGWs who had serious allergic symptoms and high exposure to dust were at risk of respiratory symptoms. Therefore, preventive program for garment dust exposure among HBGWs is needed.

  5. Trajectories of Children's Internalizing Symptoms: The Role of Maternal Internalizing Symptoms, Respiratory Sinus Arrhythmia and Child Sex

    Science.gov (United States)

    Wetter, Emily K.; El-Sheikh, Mona

    2012-01-01

    Background: We assessed trajectories of children's internalizing symptoms as predicted by interactions among maternal internalizing symptoms, respiratory sinus arrhythmia (RSA) and child sex. Method: An ethnically and socioeconomically diverse sample of children (n = 251) participated during three study waves. Children's mean ages were 8.23 years…

  6. Study of montelukast for the treatment of respiratory symptoms of post-respiratory syncytial virus bronchiolitis in children

    DEFF Research Database (Denmark)

    Bisgaard, H.; Flores-Nunez, A.; Goh, A.;

    2008-01-01

    (RSV) bronchiolitic respiratory symptoms. OBJECTIVES: To evaluate the efficacy and safety of montelukast, 4 and 8 mg, in treating recurrent respiratory symptoms of post-RSV bronchiolitis in children in a large, multicenter study. METHODS: This was a double-blind study of 3- to 24-month-old children who...... had been hospitalized for a first or second episode of physician-diagnosed RSV bronchiolitis and who tested positive for RSV. Patients (n = 979) were randomized to placebo or to montelukast at 4 or 8 mg/day for 4 weeks (period I) and 20 weeks (period II). The primary end point was percentage symptom.......7 (0.0, 11.3) for montelukast (4 mg) minus placebo and 5.9 (0.1, 11.7) for montelukast (8 mg) minus placebo. CONCLUSIONS: In this study, montelukast did not improve respiratory symptoms of post-RSV bronchiolitis in children Udgivelsesdato: 2008/10/15...

  7. Study of montelukast for the treatment of respiratory symptoms of post-respiratory syncytial virus bronchiolitis in children

    DEFF Research Database (Denmark)

    Bisgaard, Hans; Flores-Nunez, Alejandro; Goh, Anne;

    2008-01-01

    (RSV) bronchiolitic respiratory symptoms. OBJECTIVES: To evaluate the efficacy and safety of montelukast, 4 and 8 mg, in treating recurrent respiratory symptoms of post-RSV bronchiolitis in children in a large, multicenter study. METHODS: This was a double-blind study of 3- to 24-month-old children who...... had been hospitalized for a first or second episode of physician-diagnosed RSV bronchiolitis and who tested positive for RSV. Patients (n = 979) were randomized to placebo or to montelukast at 4 or 8 mg/day for 4 weeks (period I) and 20 weeks (period II). The primary end point was percentage symptom.......7 (0.0, 11.3) for montelukast (4 mg) minus placebo and 5.9 (0.1, 11.7) for montelukast (8 mg) minus placebo. CONCLUSIONS: In this study, montelukast did not improve respiratory symptoms of post-RSV bronchiolitis in children....

  8. The capsaicin cough reflex in eczema patients with respiratory symptoms elicited by perfume.

    Science.gov (United States)

    Elberling, Jesper; Dirksen, Asger; Johansen, Jeanne Duus; Mosbech, Holger

    2006-03-01

    Respiratory symptoms elicited by perfume are common in the population but have unclear pathophysiology. Increased capsaicin cough responsiveness has been associated with the symptoms, but it is unknown whether the site of the symptoms in the airways influences this association. The aim of this study was to investigate the association between the site of airway symptoms elicited by perfume and cough responsiveness to bronchial challenge with capsaicin. 21 eczema patients with respiratory symptoms elicited by perfume were compared with 21 healthy volunteers in a sex- and age-matched case control study. The participants completed a symptom questionnaire and underwent a bronchial challenge with capsaicin. Lower, but not upper, respiratory symptoms elicited by perfume were associated with increased capsaicin cough responsiveness. Having severe symptoms to perfume (n=11) did not relate to the site of the symptoms in the airways and was not associated with increased capsaicin cough responsiveness. In conclusion, respiratory symptoms elicited by perfume may reflect local hyperreactivity related to defensive reflexes in the airways, and measurements of the capsaicin cough reflex are relevant when patients with lower respiratory symptoms related to environmental perfume exposures are investigated.

  9. 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

  10. Carbon monoxide and respiratory symptoms in young adult passive smokers: A pilot study comparing waterpipe to cigarette

    Directory of Open Access Journals (Sweden)

    Rouba Zeidan

    2014-08-01

    Full Text Available Objectives: Studies have correlated second hand smoke (SHS with many diseases, especially respiratory effects. The goal of this study was to measure the impact of SHS on the respiratory symptoms and exhaled carbon monoxide. Material and Methods: The study population consisted of 50 young workers in restaurants serving waterpipes, 48 university students who sit frequently in the university cafeteria where cigarette smoking is allowed and 49 university students spending time in places where smoking is not allowed. Subjects completed questionnaires on socio-demographic characteristics, respiratory symptoms and exposure to SHS. Exhaled carbon monoxide levels were measured. ANOVA and Chi-square tests were used when applicable as well as linear and logistic regression analysis. Results: Exposure to cigarette smoke in university (adjusted odds ratio (ORa = 6.06 and occupational exposure to waterpipe smoke (ORa = 7.08 were predictors of chronic cough. Being married (ORa = 6.40, living near a heavy traffic road (ORa = 9.49 or near a local power generator (ORa = 7.54 appeared responsible for chronic sputum production. Moreover, predictors of chronic allergies were: being male (ORa = 7.81, living near a local power generator (ORa = 5.52 and having a family history of chronic respiratory diseases (ORa = 17.01. Carbon monoxide levels were augmented by the number of weekly hours of occupational exposure to waterpipe smoke (β = 1.46 and the number of daily hours of exposure to cigarette smoke (β = 1.14. Conclusions: In summary, young non-smoker subjects demonstrated more chronic cough and elevated carbon monoxide levels when exposed to SHS while the effect of waterpipe was even more evident.

  11. 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

  12. Respiratory symptoms and asthma in primary school children in Kuala Lumpur.

    Science.gov (United States)

    Omar, A H

    1990-04-01

    In a cross-sectional study of 7 to 12-year-old primary school children in Kuala Lumpur, the prevalence of chronic cough and/or phlegm, persistent wheeze, and doctor-diagnosed asthma were 8.0%, 8.0% and 8.7%, respectively. The prevalence of asthma (defined as persistent wheeze and/or doctor-diagnosed asthma) was 13.8%. 4.3% experienced at least one episode of chest illness that resulted in inactivity for at least 3 days in the previous year. The mean age of commencement of symptoms in the doctor-diagnosed asthma group was 2.75 years. The prevalence of chronic cough and/or phlegm and persistent wheeze were highest among Indian children (p less than 0.05). More Malays had been diagnosed as having asthma than the other ethnic groups but the differences were not statistically significant. The patients' fathers' low levels of education were associated with chronic cough and/or phlegm (p less than 0.05) but not with other complaints. Asthma was significantly more common among boys than girls. No age differences were noted. Further analysis showed that persistent wheeze and doctor-diagnosed asthma were associated with increased likelihood of other respiratory illnesses or doctor-diagnosed allergy before the age of 2 years.

  13. The capsaicin cough reflex in eczema patients with respiratory symptoms elicited by perfume

    DEFF Research Database (Denmark)

    Elberling, Jesper; Dirksen, Asger; Johansen, Jeanne Duus;

    2006-01-01

    Respiratory symptoms elicited by perfume are common in the population but have unclear pathophysiology. Increased capsaicin cough responsiveness has been associated with the symptoms, but it is unknown whether the site of the symptoms in the airways influences this association. The aim of this st......Respiratory symptoms elicited by perfume are common in the population but have unclear pathophysiology. Increased capsaicin cough responsiveness has been associated with the symptoms, but it is unknown whether the site of the symptoms in the airways influences this association. The aim...... of this study was to investigate the association between the site of airway symptoms elicited by perfume and cough responsiveness to bronchial challenge with capsaicin. 21 eczema patients with respiratory symptoms elicited by perfume were compared with 21 healthy volunteers in a sex- and age-matched case...... control study. The participants completed a symptom questionnaire and underwent a bronchial challenge with capsaicin. Lower, but not upper, respiratory symptoms elicited by perfume were associated with increased capsaicin cough responsiveness. Having severe symptoms to perfume (n=11) did not relate...

  14. 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

  15. 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.

  16. 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.

  17. 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.

  18. Burden of Household Smoking Habits on the Occurrence of Respiratory Symptoms among Malaysian Adolescents

    OpenAIRE

    Aziemah ZULKIFLI; Najihah Zainol ABIDIN; Abidin, Emilia Zainal; Hashim, Zailina; Irniza RASDI; Sharifah Norkhadijah Syed ISMAIL; Anita Abd RAHMAN; Man, Che Nin

    2015-01-01

    Background: This study aimed to assess the burden of household smoking habits on the occurrence of respiratory symptoms among young adolescents in Malaysia.Methodology: The impact of Secondhand Smoke (SHS) exposures on the occurrence of respiratory symptoms was investigated on 234 adolescents (13-14 years old) residing in two states in Malaysia. Adolescents completed a self-administered questionnaire adapted from Global Youth Tobacco survey that comprised of items on socio-demographic and SHS...

  19. [A case of incidentally diagnosed retroperitoneal lymphangioleiomyomatosis with no respiratory symptoms].

    Science.gov (United States)

    Tanaka, Ken; Miyazaki, Jun; Uchida, Masahiro; Ichioka, Daishi; Kimura, Tomokazu; Oikawa, Takehiro; Suetomi, Takahiro; Kawai, Koji; Uesugi, Noriko; Nasu, Katsuhiro; Nishiyama, Hiroyuki

    2013-11-01

    A 39-year-old woman presented with a large retroperitoneal tumor found incidentally in a routine examination. The 138×37×26 mm mass was located in the left paraaortic region. Blood tests and urinalyses including endocrinological examinations revealed no abnormalities. A chest computed tomography revealed multiple thin-walled pulmonary cysts, which is a characteristic of lymphangioleiomyomatosis (LAM). Because the findings strongly suggested that the retroperitoneal tumor was an extrapulmonary manifestion of LAM, we performed laparoscopic resection of the tumor for diagnosis and treatment. The pathological diagnosis was LAM. The tumor cells were immunohistochemically positive for α -smooth muscle actin and weakly positive for HMB45, which is consistent with LAM. The cells were also positive for estrogen receptor (ER) and progesterone receptor (PgR). LAM is a rare progressive disease that affects mainly the lung, and leads to chronic respiratory failure. Extrapulmonary LAM without respiratory symptoms, is extremely rare. In the past, the prognosis of LAM was poor, with a median survival of 8-10 years, but now 85% survive more than 10 years. In the present case, deterioration of pulmonary lesions was not observed during the 10 months follow-up. Because ERand PgRfindings were positive, we will consider hormonal therapy as a treatment option, when the pulmonary lesions progress in the present case.

  20. Respiratory symptoms among industrial workers exposed to water aerosol. A pilot study of process water and air microbial quality

    Directory of Open Access Journals (Sweden)

    Bożena Krogulska

    2013-02-01

    Full Text Available Background: The frequency of respiratory symptoms in workers exposed to water aerosol was evaluated along with the preliminary assessment of microbiological contamination of air and water used in glass processing plants. Material and Methods: A questionnaire survey was conducted in 131 workers from 9 glass processing plants. Questions focused on working conditions, respiratory symptoms and smoking habits. A pilot study of air and water microbiological contamination in one glass processing plant was performed. Water samples were tested for Legionella in accordance with EN ISO 11731-2:2008 and for total colony count according to PN-EN ISO 6222:2004. Air samples were tested for total numbers of molds and mildews. Results: During the year preceding the survey acute respiratory symptoms occurred in 28.2% of participants, while chronic symptoms were reported by 29% of respondents. Increased risks of cough and acute symptoms suggestive of pneumonia were found among the respondents working at a distance up to 20 m from the source of water aerosol compared to other workers (OR = 2.7, with no difference in the frequency of other symptoms. A microbiological analysis of water samples from selected glass plant revealed the presence of L. pneumophila, exceeding 1000 cfu/100 ml. The number of bacteria and fungi detected in air samples (above 1000 cfu/m3 suggested that water aerosol at workplaces can be one of the sources of the air microbial contamination. Conclusions: The questionnaire survey revealed an increased risk of cough and acute symptoms suggestive of pneumonia in the group working at a shortest distance form the source of water aerosol. Med Pr 2013;64(1:47–55

  1. Evaluation of pulmonary function and respiratory symptoms in pyrochlore mine workers

    Science.gov (United States)

    Borges, Ritta de Cássia Canedo Oliveira; Barros, José Cerqueira; Oliveira, Fabrício Borges; Brunherotti, Marisa Andrade; Quemelo, Paulo Roberto Veiga

    2016-01-01

    ABSTRACT Objective: To identify respiratory symptoms and evaluate lung function in mine workers. Methods: This was a cross-sectional observational study involving production sector workers of a pyrochlore mining company. The subjects completed the British Medical Research Council questionnaire, which is designed to evaluate respiratory symptoms, occupational exposure factors, and smoking status. In addition, they underwent pulmonary function tests with a portable spirometer. Results: The study involved 147 workers (all male). The mean age was 41.37 ± 8.71 years, and the mean duration of occupational exposure was 12.26 ± 7.09 years. We found that 33 (22.44%) of the workers had respiratory symptoms and that 26 (17.69%) showed abnormalities in the spirometry results. However, we found that the spirometry results did not correlate significantly with the presence of respiratory symptoms or with the duration of occupational exposure. Conclusions: The frequencies of respiratory symptoms and spirometric changes were low when compared with those reported in other studies involving occupational exposure to dust. No significant associations were observed between respiratory symptoms and spirometry results.

  2. Risco aumentado de sintomas respiratórios e bronquite crônica em mulheres que utilizam biocombustíveis na Nigéria Increased risk of respiratory symptoms and chronic bronchitis in women using biomass fuels in Nigeria

    Directory of Open Access Journals (Sweden)

    Olufemi Olumuyiwa Desalu

    2010-08-01

    Full Text Available OBJETIVO: Determinar a associação de sintomas respiratórios e bronquite crônica com o uso de biocombustíveis entre mulheres habitantes de áreas rurais do estado de Ekiti, sudoeste da Nigéria. MÉTODOS: De janeiro a junho de 2009, realizou-se um estudo transversal com uma amostra de 269 mulheres adultas. Um questionário adaptado do European Community Respiratory Health Survey foi aplicado para a obtenção de dados sobre características sociodemográficas, tipo de combustível utilizado para a preparação de alimentos, sintomas respiratórios e história de tabagismo. Todas as participantes foram convidadas a realizar espirometria. RESULTADOS: Das 269 mulheres no estudo, 161 (59,9% utilizavam biocombustíveis para a preparação de alimentos. As mulheres que utilizavam biocombustíveis relataram mais sintomas respiratórios que aquelas que não os utilizavam - tosse (13,7% vs. 3,7%; sibilância (8,7% vs. 2,8%; dor no peito (7,5% vs. 1,9%; falta de ar (11,8% vs. 6,5%; sintomas nasais (9,3% vs. 4,6%; e bronquite crônica (10,6% vs. 2,8%. A análise multivariada por regressão logística confirmou que o uso de biocombustíveis está associado às seguintes variáveis: tosse (OR = 4,82; p = 0,01; bronquite crônica (OR = 3,75; p = 0,04; sibilância (OR = 2,22; p = 0,23; dor no peito (OR = 3,82; p = 0,09; falta de ar (OR = 1,54; p = 0,35; e sintomas nasais (OR = 2,32; p = 0,20. Todos os parâmetros espirométricos avaliados (VEF1, CVF, VEF1/CVF e PFE foram menores nas mulheres que utilizavam biocombustíveis do que naquelas que não os utilizavam. CONCLUSÕES: Nossos resultados enfatizam a necessidade de se substituir o uso de biocombustíveis nos domicílios pelo de um tipo de combustível atóxico, como eletricidade ou gás.OBJECTIVE: To determine whether respiratory symptoms and chronic bronchitis are associated with the use of biomass fuels (BMFs among women residing in rural areas of the Ekiti State, in southwestern Nigeria. METHODS

  3. A STUDY TO EVALUATE RESPIRATORY SYMPTOMS AND LUNG FUNCTION IMPAIRMENT IN BEEDI WORKERS AND USEFULLNESS OF PROTECTIVE MASK IN REDUCING RESPIRATORY SYMPTOMS

    Directory of Open Access Journals (Sweden)

    Mahesh V Hegde

    2015-04-01

    Full Text Available Background and Purpose: Problems of the occupational health management are posing serious challenges before the mankind globally. Occupational disease if unaddressed leads to deviation from health. The aim of the study is to study the prevalence of respiratory symptoms and lung function abnormalities and to find out the usefulness of protective mask in reducing respiratory symptoms in tobacco workers. Materials and Methods: Quasi experimental study includes those workers exposed to tobacco dust in beedi industry recruited with minimum of three years of experience and age group of 20 to 40 years. Control group includes age and sex matched subjects who are not exposed to tobacco dust. Results: There were significant difference exist between experimental and control group in the prevalence of respiratory symptoms. How ever there was no significant difference between FEV1 and FEF (25-75 between two groups. Conclusion: Prevalence of respiratory symptoms was found to be in beedi workers and the ventilatory capacity data were similar in both the groups.

  4. Immune parameters, symptoms of upper respiratory tract infections, and training-load indicators in volleyball athletes

    Directory of Open Access Journals (Sweden)

    Dias R

    2011-12-01

    Full Text Available Rodrigo Dias1, Anelena Bueno Frollini1, Diego Trevisan Brunelli1, André Katayama Yamada1, Richard Diego Leite4, Ricardo Adamoli Simões1, Guilherme Souza Lobo Salles1, Débora Trevisan1, Idico Luiz Pellegrinotti1, Marcelo de Castro César1, Silvia Cristina Crepaldi Alves1, Rozangela Verlengia1, João Paulo Borin2, Jonato Prestes2,3, Claudia Regina Cavaglieri21Núcleo de Performance Humana, Mestrado em Educação Física, Faculdade de Ciências da Saúde, Universidade Metodista de Piracicaba, São Paulo, Brasil; 2Faculdade de Educação Física (FEF Universidade Estadual de Campinas – UNICAMP, Campinas, Brasil; 3Programa de Mestrado e Doutorado em Educação Física, Universidade Católica de Brasília, Brasília, Brasil; 4Laboratório de Pesquisa Clínica e Experimental em Biologia Vascular (BioVasc, Departamento de Ciências Fisiológicas, Universidade Estadual do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, BrasilBackground: The control of immunological alterations becomes important during in-season training, as a result of increased incidence of infectious diseases, and may assist in avoiding interruptions to training due to illness.Objective: The aim of the present study was to evaluate 28 weeks of chronic immune modulations in female volleyball athletes.Methods: The sample was composed of twelve athletes aged 19.47 ± 2.49 years, height 1.78 ± 0.08 cm, and body mass 66.77 ± 7.8 kg. Leukocytes, individual immune cell count, interleukin (IL-2, IL-6, and tumor necrosis factor (TNF-α plasma cytokines were measured during the competitive period.Results: Results revealed that immune variables were correlated with symptoms of upper respiratory tract infections and training-load indicators, indicating a possible marker of immune status. There was a statistically significant increase in total leukocytes, neutrophils, and monocyte count, a decrease in lymphocytes, and an increase in upper respiratory tract infection symptoms, with no change

  5. Rapid declines in FEV1 and subsequent respiratory symptoms, illnesses, and mortality in coal miners in the United States

    Energy Technology Data Exchange (ETDEWEB)

    Beeckman, L.A.F.; Wang, M.L.; Petsonk, E.L.; Wagner, G.R. [NIOSH, Morgantown, WV (USA). Division of Respiratory District Studies, Center for District Control and Prevention and Human Services

    2001-03-01

    Coal mine dust exposure is associated with accelerated loss of lung function. The authors assessed long-term health outcomes in two groups of underground coal miners who during previous mine surveys had shown either high rates of FEV1 decline (cases, n = 310) or relatively stable lung function (referents, n = 324). Cases and referents were matched initially for age, height, smoking status, and FEV,. The authors determined vital status for 561 miners, and obtained a follow-up questionnaire for 121 cases and 143 referents. Responses on the follow-up questionnaire were compared with those on the last previous mine health survey questionnaire. Cases showed a greater incidence of symptoms than did referents for cough, phlegm production, Grades II and III dyspnea, and wheezing, and greater incidences than referents of chronic bronchitis and self-reported asthma and emphysema. More cases than referents (15% versus 4%) left mining before retirement because of chest illnesses. After controls were applied for age and smoking, cases had twice the risk of dying of cardiovascular and nonmalignant respiratory diseases and a 3.2-fold greater risk of dying of chronic obstructive pulmonary disease than did referents. Rapid declines in FEV1 experienced by some coal miners are associated with subsequent increases in respiratory symptoms, illnesses, and mortality from cardiovascular and nonmalignant respiratory diseases.

  6. Respiratory Symptoms and Dust Exposure Among Male Workers in Small-Scale Wood Industries in Tanzania

    OpenAIRE

    Rongo, L.M.B.; Besselink, A.V.; Douwes, J; Barten, F.J.M.H.; Msamanga, G I; Dolmans, W.M.V.; Demers, P.A.; Heederik, D.

    2002-01-01

    Few studies have assessed respiratory symptoms and dust exposure levels in small-scale wood industry workers in Africa. We interviewed 546 workers exposed to wood dust and 565 control subjects using a respiratory health questionnaire. Inhalable dust measurements were collected for 106 workers. The dust exposure was high, and job title–based geometric mean exposure levels ranged from 2.9 to 22.8 mg/m3 . Prevalence of respiratory symptoms in the previous 12 months was significantly higher in th...

  7. 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.

  8. Illness behaviour and antibiotic prescription in patients with respiratory tract symptoms.

    NARCIS (Netherlands)

    Duijn, H.J. van; Kuyvenhoven, M.M.; Schellevis, F.G.; Verheij, T.J.M.

    2007-01-01

    BACKGROUND: Although the vast majority of respiratory tract symptoms are self-limiting, many patients visit their GP for these symptoms and antibiotics are over-prescribed. AIM: To explore determinants of patients visiting GPs for recent cough, sore throat, or earache; for being prescribed antibioti

  9. The Diagnostic Value of Serum C-Reactive Protein for Identifying Pneumonia in Hospitalized Patients with Acute Respiratory Symptoms

    Science.gov (United States)

    Utrillo, Laia; Bielsa, Silvia; Falguera, Miquel; Porcel, José M.

    2016-01-01

    Background. The clinical diagnosis of pneumonia is sometimes difficult since chest radiographs are often indeterminate. In this study, we aimed to assess whether serum C-reactive protein (CRP) could assist in identifying patients with pneumonia. Methods. For one winter, all consecutive patients with acute respiratory symptoms admitted to the emergency ward of a single center were prospectively enrolled. In addition to chest radiographs, basic laboratory tests, and microbiology, serum levels of CRP were measured at entry. Results. A total of 923 (62.3%) of 1473 patients hospitalized for acute respiratory symptoms were included. Subjects with a final diagnosis of pneumonia had higher serum CRP levels (median 187 mg/L) than those with exacerbations of chronic obstructive pulmonary disease (63 mg/L) or acute bronchitis (54 mg/L, p CRP was accurate in identifying pneumonia (area under the curve 0.84, 95% CI 0.82–0.87). The multilevel likelihood ratio (LR) for intervals of CRP provided useful information on the posttest probability of having pneumonia. CRP intervals above 200 mg/L were associated with LR+ > 5, for which pneumonia is likely, whereas CRP intervals below 75 mg/L were associated with LR CRP may be a useful addition for diagnosing pneumonia in hospitalized patients with acute respiratory symptoms. PMID:27610265

  10. Validation of a pediatric caregiver diary to measure symptoms of postacute respiratory syncytial virus bronchiolitis

    DEFF Research Database (Denmark)

    Santanello, Nancy C; Norquist, Josephine M; Nelsen, Linda M;

    2005-01-01

    Acute respiratory syncytial virus (RSV)-induced bronchiolitis is often associated with continuing respiratory symptoms following hospitalization. To date, there is no validated objective measure to evaluate symptoms of RSV-induced bronchiolitis. We report on the reliability, validity......, and responsiveness of the bronchiolitis caregiver diary (BCD) of symptoms and healthcare utilization associated with postacute RSV. The BCD measures four symptoms (daytime cough, wheeze, trouble breathing, and nighttime cough), healthcare utilization, and rescue medication for worsening of lung symptoms. Data from......-group differences were statistically significant in the appropriate direction. Responsiveness analyses indicated moderate effect sizes for percentage of SFD. In conclusion, the BCD provides a valid, reliable, and responsive tool for the assessment of symptoms of postacute RSV-induced bronchiolitis, capable...

  11. Symptoms and their correlates in chronic kidney disease.

    Science.gov (United States)

    Weisbord, Steven D

    2007-10-01

    While there is a significant body of literature documenting the impairments in health-related quality of life (HRQOL) experienced by patients with end-stage renal disease (ESRD), recent work has helped to elucidate the mediators of impaired well-being in this patient group. Physical and emotional symptoms have been shown to be common, frequently severe, and directly linked with impaired HRQOL. The following review explores the process of symptom assessment in patients with chronic kidney disease (CKD), presents an overview of the composite burden and importance of symptoms in patients with ESRD, highlights particularly common and distressing symptoms for which existing treatment strategies may be applicable, and discusses future directions for efforts to address and alleviate symptoms in the growing population of patients who suffer from CKD.

  12. Prevalence of Chronic Fatigue Syndrome-Related Symptoms among Nurses.

    Science.gov (United States)

    Jason, Leonard A.; And Others

    1993-01-01

    The prevalence of chronic fatigue syndrome among 1,474 nurses was addressed through a mailed questionnaire (202 respondents). Demographic characteristics, symptoms, and possible prevalence rates are presented and discussed. Implications of these findings are considered, and the methodology used is analyzed. Suggestions are made for conducting…

  13. 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

  14. 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...

  15. 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

  16. Effects of ambient air pollution on upper and lower respiratory symptoms and peak expiratory flow in children

    NARCIS (Netherlands)

    Boezen, H M; van der Zee, S C; Postma, D S; Vonk, J M; Gerritsen, J; Hoek, G; Brunekreef, B; Rijcken, B; Schouten, J P

    1999-01-01

    BACKGROUND: Previous epidemiological studies have shown acute effects of increased amounts of ambient air pollution on the prevalence of respiratory symptoms in children with respiratory disorders. We investigated whether children with bronchial hyperresponsiveness (BHR) and relatively high serum co

  17. Neuromuscular Strain Increases Symptom Intensity in Chronic Fatigue Syndrome

    Science.gov (United States)

    Rowe, Peter C.; Fontaine, Kevin R.; Lauver, Megan; Jasion, Samantha E.; Marden, Colleen L.; Moni, Malini; Thompson, Carol B.; Violand, Richard L.

    2016-01-01

    Chronic fatigue syndrome (CFS) is a complex, multisystem disorder that can be disabling. CFS symptoms can be provoked by increased physical or cognitive activity, and by orthostatic stress. In preliminary work, we noted that CFS symptoms also could be provoked by application of longitudinal neural and soft tissue strain to the limbs and spine of affected individuals. In this study we measured the responses to a straight leg raise neuromuscular strain maneuver in individuals with CFS and healthy controls. We randomly assigned 60 individuals with CFS and 20 healthy controls to either a 15 minute period of passive supine straight leg raise (true neuromuscular strain) or a sham straight leg raise. The primary outcome measure was the symptom intensity difference between the scores during and 24 hours after the study maneuver compared to baseline. Fatigue, body pain, lightheadedness, concentration difficulties, and headache scores were measured individually on a 0–10 scale, and summed to create a composite symptom score. Compared to individuals with CFS in the sham strain group, those with CFS in the true strain group reported significantly increased body pain (P = 0.04) and concentration difficulties (P = 0.02) as well as increased composite symptom scores (all P = 0.03) during the maneuver. After 24 hours, the symptom intensity differences were significantly greater for the CFS true strain group for the individual symptom of lightheadedness (P = 0.001) and for the composite symptom score (P = 0.005). During and 24 hours after the exposure to the true strain maneuver, those with CFS had significantly higher individual and composite symptom intensity changes compared to the healthy controls. We conclude that a longitudinal strain applied to the nerves and soft tissues of the lower limb is capable of increasing symptom intensity in individuals with CFS for up to 24 hours. These findings support our preliminary observations that increased mechanical sensitivity may be a

  18. Respiratory symptoms and pulmonary function of workers employed in textile dyeing factory in Turkey.

    Science.gov (United States)

    Sibel, O; Beyza, A; Murat, K; Fatma, E; Göksel, K; Sevin, B

    2012-08-01

    Dyes are known to be a causative agent of occupational asthma exposed to them. We evaluate respiratory symptoms among textile. The study population comprised 106 exposed workers and control (unexposed) group. Data were collected by a questionnaire. Pulmonary Function Tests (PFTs) were performed. Among the exposed workers 36.8% defined phlegm. Respiratory symptoms were not significantly different between two groups. The employment duration of the exposed workers with phlegm was longer than those without phlegm (p = 0.027). The mean % predicted of forced expiratory flow (FEF) 25-75 of the exposed workers was found to be significantly lower than the control (unexposed) group (p = 0.01). Our study suggests that textile dyeing might cause respiratory symptoms at workers.

  19. Respiratory rehabilitation: a physiotherapy approach to the control of asthma symptoms and anxiety

    OpenAIRE

    Renata André Laurino; Viviane Barnabé; Saraiva-Romanholo, Beatriz M.; Rafael Stelmach; Alberto Cukier; Nunes, Maria do Patrocínio T.

    2012-01-01

    OBJECTIVES: The objectives of this study were to verify the degree of anxiety, respiratory distress, and health-related quality of life in a group of asthmatic patients who have experienced previous panic attacks. Additionally, we evaluated if a respiratory physiotherapy program (breathing retraining) improved both asthma and panic disorder symptoms, resulting in an improvement in the health-related quality of life of asthmatics. METHODS: Asthmatic individuals were assigned to a chest physiot...

  20. 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.

  1. Health outcomes associated with lung function decline and respiratory symptoms and disease in a community cohort

    DEFF Research Database (Denmark)

    Baughman, Penelope; Marott, Jacob L; Lange, Peter;

    2011-01-01

    's Longitudinal Normal Limit [LNL], or a limit of 90 milliliters per year [ml/yr]). These risks were estimated by hazard ratios (HR) and 95% confidence intervals (CI) adjusted for age, height-adjusted baseline forced expiratory volume in 1 second (FEV(1)/height(2)), and height. RESULTS: For COPD morbidity......BACKGROUND: In workplace respiratory disease prevention, a thorough understanding is needed of the relative contributions of lung function loss and respiratory symptoms in predicting adverse health outcomes. METHODS: Copenhagen City Heart Study respiratory data collected at 4 examinations (1976...

  2. [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

  3. [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

  4. Associations between chronic pelvic pain and psychiatric disorders and symptoms

    Directory of Open Access Journals (Sweden)

    ANA CAROLINA FRANCO CARVALHO

    2015-02-01

    Full Text Available Background Chronic pelvic pain (CPP is a complex condition wich is associated with emotional factors, specially depression and anxiety. Objectives To make a systematic review to provide a detailed summary of relevant literature on the association between CPP and different psychiatric disorders/symptoms. Methods A systematic review of articles in the international literature published between 2003 and 2014 was performed in the electronic databases PubMed, PsycINFO, LILACS, and SciELO using the terms (chronic pelvic pain AND (psychiatry OR psychiatric OR depression OR anxiety OR posttraumatic stress OR somatoform. The searches returned a total of 529 matches that were filtered according to predefined inclusion and exclusion criteria. A total of 18 articles were selected. Results The investigations focused mainly on the assessment of depression and anxiety disorders/symptoms, with rather high rates (17-38.6%. Depression and anxiety symptoms were more prevalent among women with CPP compared to healthy groups. Comparisons between groups with CPP and with specific pathologies that also have pain as a symptom showed that depression indicators are more frequent in CPP. Depressive symptoms tend to be more common in CPP and have no particular association with pain itself, the core feature of CPP. Discussion Other aspects of CPP seem to play a specific role in this association. Anxiety and other psychiatric disorders require further investigation so that their impact on CPP can be better understood.

  5. AN OVERVIEW ON SYMPTOMS CAUSES TEST TREATMENT FOR CHRONIC OBSTRUCTIVE PULMONARY DISEASE

    Directory of Open Access Journals (Sweden)

    Shailendra Wasnik

    2012-01-01

    Full Text Available Chronic obstructive pulmonary disease (COPD has a dramatic effect on quality of life. The need to formulate a different set of parameters for peoples was felt because of the differences in risk factors, disease prevalence and pattern, and above all, the different overall health-care infrastructure. Moreover a large burden of tuberculosis, which is an important cause of cough, adds to the difficulties of diagnosis and management. Worldwide, COPD ranked as the sixth leading cause of death in 1990. It is projected to be the fourth leading cause of death worldwide by 2030 due to an increase in smoking rates and demographic changes in many countries. When the damage is severe, it may become difficult to get enough oxygen into the blood and to get rid of excess carbon dioxide. These changes lead to shortness of breath and other symptoms. Unfortunately, the symptoms of chronic obstructive pulmonary disease cannot be completely eliminated with treatment and the condition usually worsens over time. However, treatment can control symptoms and can sometime slow the progression of the disease. More than 12 million people are currently diagnosed with COPD. An additional 12 million probably have the disease and don't know it. COPD has received scant attention in comparison to other respiratory conditions such as asthma and lung cancer. Respiratory physicians around the world now believe the attitude of little can done for this self inflicted disease is not justifiable. Attempts have been made to redress this deficit with the recent introduction of guidelines in the management and care of patients with COPD by both the American Thoracic Society and European Respiratory Society. So this review provides the overall knowledge about the COPD as well as their management.

  6. Effect of smoking on lung function, respiratory symptoms and respiratory diseases amongst HIV-positive subjects: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Thabane Lehana

    2010-03-01

    Full Text Available Abstract Background Smoking prevalence in human immunodeficiency virus (HIV positive subjects is about three times of that in the general population. However, whether the extremely high smoking prevalence in HIV-positive subjects affects their lung function is unclear, particularly whether smoking decreases lung function more in HIV-positive subjects, compared to the general population. We conducted this study to determine the association between smoking and lung function, respiratory symptoms and diseases amongst HIV-positive subjects. Results Of 120 enrolled HIV-positive subjects, 119 had an acceptable spirogram. Ninety-four (79% subjects were men, and 96 (81% were white. Mean (standard deviation [SD] age was 43.4 (8.4 years. Mean (SD of forced expiratory volume in one second (FEV1 percent of age, gender, race and height predicted value (%FEV1 was 93.1% (15.7%. Seventy-five (63% subjects had smoked 24.0 (18.0 pack-years. For every ten pack-years of smoking increment, %FEV1 decreased by 2.1% (95% confidence interval [CI]: -3.6%, -0.6%, after controlling for gender, race and restrictive lung function (R2 = 0.210. The loss of %FEV1 in our subjects was comparable to the general population. Compared to non-smokers, current smokers had higher odds of cough, sputum or breathlessness, after adjusting for highly active anti-retroviral therapy (HAART use, odds ratio OR = 4.9 (95% CI: 2.0, 11.8. However respiratory symptom presence was similar between non-smokers and former smokers, OR = 1.0 (95% CI: 0.3, 2.8. All four cases of COPD (chronic obstructive pulmonary disease had smoked. Four of ten cases of restrictive lung disease had smoked (p = 0.170, and three of five asthmatic subjects had smoked (p = 1.000. Conclusions Cumulative cigarette consumption was associated with worse lung function; however the loss of %FEV1 did not accelerate in HIV-positive population compared to the general population. Current smokers had higher odds of respiratory symptoms

  7. Industrial hygiene, occupational safety and respiratory symptoms in the Pakistani cotton industry

    OpenAIRE

    Khan, Abdul Wali; Moshammer, Hanns Michael; Kundi, Michael

    2015-01-01

    Objectives In the cotton industry of Pakistan, 15 million people are employed and exposed to cotton dust, toxic chemicals, noise and physical hazards. The aim of this study was to determine the prevalence of health symptoms, particularly respiratory symptoms, and to measure cotton dust and endotoxin levels in different textile factories of Faisalabad, Pakistan. Methods A cross-sectional investigation was performed in a representative sample of 47 cotton factories in the Faisalabad region in P...

  8. Associations between chronic pelvic pain and psychiatric disorders and symptoms

    OpenAIRE

    ANA CAROLINA FRANCO CARVALHO; OMERO BENEDITO POLI NETO; JOSÉ ALEXANDRE DE SOUZA CRIPPA; JAIME EDUARDO CECÍLIO HALLAK; FLÁVIA DE LIMA OSÓRIO

    2015-01-01

    Background Chronic pelvic pain (CPP) is a complex condition wich is associated with emotional factors, specially depression and anxiety. Objectives To make a systematic review to provide a detailed summary of relevant literature on the association between CPP and different psychiatric disorders/symptoms. Methods A systematic review of articles in the international literature published between 2003 and 2014 was performed in the electronic databases PubMed, PsycINFO, LILACS, and SciELO using th...

  9. Respiratory symptoms and ex vivo cytokine release are associated in workers processing herring

    DEFF Research Database (Denmark)

    Bønløkke, Jakob Hjort; Thomassen, Mads; Viskum, Sven;

    2004-01-01

    OBJECTIVE: To determine the prevalence of respiratory symptoms among workers processing herring and assess ex vivo cytokine release in response to agents at their workplace. METHODS: We applied a questionnaire, and performed skin prick testing and pulmonary investigations in 36 workers at two her...

  10. Brief Report: Social Skills, Internalizing and Externalizing Symptoms, and Respiratory Sinus Arrhythmia in Autism

    Science.gov (United States)

    Neuhaus, Emily; Bernier, Raphael; Beauchaine, Theodore P.

    2014-01-01

    Theoretical and empirical models describe respiratory sinus arrhythmia (RSA) as a peripheral biomarker of emotion regulation and social competence. Recent findings also link RSA to individual differences in social functioning within autism spectrum disorder (ASD). However, associations between RSA and symptoms of internalizing/externalizing…

  11. Views on respiratory tract symptoms and antibiotics of Dutch general practitioners, practice staff and patients

    NARCIS (Netherlands)

    van Duijn, HJ; Kuyvenhoven, MA; Schellevis, FG; Verheij, TJM

    2006-01-01

    Objectives: To explore views on respiratory tract symptoms (cough, sore throat and earache) and antibiotics of GPs, practice staff, and patients. Methods: In a nationwide study, 181 GPs, 204 practice staff members and 1250 patients from 90 practices participated by answering 14 items relating to vie

  12. Pulmonary function and respiratory symptoms of school children exposed to ambient air pollution

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Yoon Shin; Ko, Ung Ring [Hanyang Univ., Seoul (Korea, Republic of)

    1996-12-31

    This study was undertaken to evaluate the health effect of air pollution on pulmonary function and respiratory symptoms of Korean school children between 7 and 10 years of age during November 1995-January 1996. A standard respiratory symptom questionnaire was administered and spirometry was performed to examine pulmonary function of 121 children in an urban polluted area, Seoul, and of 119 children in non-polluted area, Sokcho, respectively. There was significant difference in the level of pulmonary function [forced expiratory volume in second (FEV{sub 1.0}) and forced vital capacity (FVC)] between exposed groups to polluted area and non-polluted area. Parental smoking was significantly related to respiratory symptoms of cough, phlegm, and the level of pulmonary function. The observed changes in FEV{sub 1.0} and FVC seemed to relate to home cooking fuel, not to respiratory symptoms. The additional longitudinal work that carefully monitors ambient and indoor air pollution and health effects data should be conducted to confirm these results.

  13. Is there a threshold concentration of cat allergen exposure on respiratory symptoms in adults?

    NARCIS (Netherlands)

    Chen, C.M.; Thiering, E.; Zock, J.P.; Villani, S.; Olivieri, M.; Modig, L.; Jarvis, D.; Norbäck, D.; Verlato, G.; Heinrich, J.

    2015-01-01

    Background and Objective: Cat allergen concentrations higher than 8 μg/g in settled house dust, have been suggested to provoke exacerbation of allergic respiratory symptoms. However, whether the 8μg/g of indoor cat allergen concentration is indeed the minimal exposure required for triggering the ast

  14. Point-of-care ultrasonography in patients admitted with respiratory symptoms

    DEFF Research Database (Denmark)

    Laursen, Christian B; Sloth, Erik; Lassen, Annmarie Touborg;

    2014-01-01

    of the heart, lungs, and deep veins in addition to the usual initial diagnostic testing in this patient population. METHODS: In a prospective, parallel-group trial in the emergency department at Odense University Hospital, Odense, Denmark, patients (≥18 years) with a respiratory rate of more than 20 per min......BACKGROUND: When used with standard diagnostic testing, point-of-care ultrasonography might improve the proportion of patients admitted with respiratory symptoms who are correctly diagnosed 4 h after admission to the emergency department. We therefore assessed point-of-care ultrasonography...... diagnosis within 4 h. It should therefore be considered for routine use as part of the standard diagnostic tests in the emergency department for patients admitted with respiratory symptoms. FUNDING: University of Southern Denmark, Odense University Hospital, and Højbjerg Fund....

  15. RESPIRATORY SYMPTOMS OF VENDORS IN AN OPEN AIR HAWKER CENTRE IN BRUNEI DARUSSALAM

    Directory of Open Access Journals (Sweden)

    Nurul Nor Nazurah ebt Abdul Wahid

    2014-10-01

    Full Text Available ObjectivesWe studied respiratory problems among vendors exposed to cooking fumes in an open-air hawker centre. Exposure to cooking fumes from either the use of fossil fuels or liquefied petroleum gas (LPG has been shown to be associated with adverse respiratory health effects.Methods We conducted a cross-sectional study among 67 food vendors exposed to cooking fumes as well as 18 merchandise sellers at an open-air hawker centre in Brunei Darussalam. Past medical and smoking history and exposure to cooking fumes were obtained. The validated American Thoracic Society (ATS Questionnaire with a translated Malay version was used to ask for respiratory symptoms. Results Compared to merchandise sellers (n=18, cooking vendors (n=67 had a higher self-reported respiratory symptoms (50.7% for those cooking and 33.3% for merchandise sellers. Cough (28.3% was the main respiratory symptom experienced in cooking vendors and breathlessness (22.2% among merchandise sellers. Half (50.0% of cooking vendors who worked for more than 10 years had cough and 27.3% had phlegm. Those cooking with charcoal were two times more likely to have cough than those cooking with LPG. Cooking vendors with a job duration of more than 10 years were thrice more likely to have cough.Conclusion Cooking vendors in the open air hawker centre exposed to cooking fumes had more respiratory symptoms compared to non-exposed merchandise sellers. The type of fuel used for cooking and duration of work were associated with increased prevalence of cough.

  16. 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

  17. Lung function and respiratory symptoms in a randomized smoking cessation trial of electronic cigarettes.

    Science.gov (United States)

    Cibella, Fabio; Campagna, Davide; Caponnetto, Pasquale; Amaradio, Maria Domenica; Caruso, Massimo; Russo, Cristina; Cockcroft, Donald W; Polosa, Riccardo

    2016-11-01

    Quitting smoking is the most important step smokers can take to improve their health. Nonetheless, there is little information on long-term improvements in lung function and/or respiratory symptoms after smoking cessation. Here we illustrate long-term changes in spirometric indices as well as in respiratory symptoms in smokers invited to quit or reduce their cigarette consumption by switching to electronic cigarettes (ECs). Prospective evaluation of cigarette consumption, spirometry and symptoms was performed in a 1-year randomized controlled trial of smokers receiving EC containing 2.4%, 1.8% or 0% nicotine. Spirometric data are presented on the basis of participants' pooled continuous smoking phenotype classification (Quitters, Reducers, Failures), whereas respiratory symptoms on the basis of their point prevalence-smoking phenotype. Smoking phenotype classification (Quitters, Reducers, Failures) had no significant effect on spirometric indices (FEV1, FVC and FEV1/FVC) with the exception of FEF25-75%, which significantly (P  =0.034) increased over the time among Quitters; their FEF25-75% (% predicted) improving from (means±S.D.) 85.7±15.6% at baseline (BL) to 100.8±14.6%. High prevalence of cough/phlegm (43.1%) and shortness of breath (SoB; 34.8%) was reported at BL with substantial reduction in their frequency at subsequent follow-up visits. These symptoms virtually disappeared very quickly in both quitters and reducers. Smokers invited to switch to ECs who completely abstained from smoking showed steady progressive improvements in their FEF25-75% Normalization of peripheral airways function was associated with improvement in respiratory symptoms, adding to the notion that abstaining from smoking can reverse tobacco harm in the lung. PMID:27543458

  18. Respiratory symptoms in primary schoolchildren living near a freeway in Taiwan.

    Science.gov (United States)

    Yang, Chun-Yuh; Yu, Sheng-Tsung; Chang, Chih-Ching

    2002-05-24

    A cross-sectional epidemiological study was conducted in an effort to investigate the effects of automobile exhaust on respiratory symptoms of school children in Kaohsiung, Taiwan. One school (Yang-Ming primary school) was located in the vicinity of 150 m from the highway and designated as a heavy-traffic area. The control school (Zhuang-Jing primary school) was situated in the same district but the distance of the school address to the freeway was 1500 m and designated as a low-traffic area. All of the primary school children in those schools were used in the study. In total, 3221 children were from the heavy-traffic school and 2969 from the low-traffic area. The respiratory health was assessed by an evaluation of the child's respiratory symptoms and illnesses using a parent-completed questionnaire. Data on traffic flow on the freeway were obtained from the Department of Transportation. Road traffic flows in front of the study schools were also measured with a portable counter. This study showed that a freeway surrounding a child's school may not be associated with an increased risk of respiratory symptoms. This may be due to insufficiently large contrasts in traffic pollution levels between these areas. PMID:12028826

  19. 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

  20. Urban air pollution and respiratory health among children with respiratory symptoms in Finland

    Energy Technology Data Exchange (ETDEWEB)

    Pekkanen, J.; Timonen, K.L.; Salonen, R.O.; Alm, S.; Reponen, A.; Jantunen, M.; Vahteristo, M. [National Public Health Inst., Kuopio (Finland); Ruuskanen, J. [Kuopio Univ. (Finland). Dept. of Environmental Sciences; Paerjaelae, E. [City of Kuopio (Finland)

    1995-12-31

    Many recent studies suggest that urban air pollution, especially thoracic particles (PM{sub 10}), are associated with increased respiratory, mortality and morbidity at lower levels than what has previously been known. During the Finnish winter, the dust formed from asphalt ware by studded auto tyres, street sanding and combustion processes is accumulated on the snow. In the spring, when the snow melts from the streets, part of this dust is resuspended by traffic and wind. This creates spring dust episodes, during which TSP and PM{sub 10} levels exceed air quality guidelines in most Finnish cities. The mechanisms through which PM{sub 10} produces its health effects are largely unknown. It has been suggested that the number of particles, especially that of very small particles in the nanometer range, would be as important as the mass or the chemical composition of the particles. In most previous studies, the particles measured have mostly composed of combustion products. There are only sparse data on the size distribution of particles in the Finnish spring dust episode and no studies on it`s possible health effects. The aim of the PEACE project was to develop a common protocol for research on the short-term relationship between respiratory health and changes in air pollution levels. The present report describes the design and preliminary results of Finnish field work of the PEACE study that was carried out in Kuopio, Eastern Finland. (author)

  1. Burden of Household Smoking Habits on the Occurrence of Respiratory Symptoms among Malaysian Adolescents

    Directory of Open Access Journals (Sweden)

    Aziemah ZULKIFLI

    2015-10-01

    Full Text Available Background: This study aimed to assess the burden of household smoking habits on the occurrence of respiratory symptoms among young adolescents in Malaysia.Methodology: The impact of Secondhand Smoke (SHS exposures on the occurrence of respiratory symptoms was investigated on 234 adolescents (13-14 years old residing in two states in Malaysia. Adolescents completed a self-administered questionnaire adapted from Global Youth Tobacco survey that comprised of items on socio-demographic and SHS exposures. Respiratory symptoms were assessed using a standard questionnaire of International Study of Asthma and Allergies in Childhood. Hair samples were collected from each adolescent and were analyzed for nicotine via Gas Chromatography-Mass Spectrophotometry with nitrogen detection method.Result: The geometric mean of hair nicotine was 0.0184± 2.31 ng/mg. The prevalence of current, ever wheeze, nocturnal cough, exercised-induced wheeze and self-reported asthma were 7.69%, 14.1%, 11.5%, 20.5% and 13.7%, respectively. A significant association was found between household smoking status with exercise-induced wheeze (Adjusted Odds Ratio, AOR 1.06; 95%Confidence Interval, CI 0.42-2.66 and nocturnal cough (AOR 14.2; 95%CI 1.60-125. Reported ever wheeze was linked to reported SHS exposure in family’s vehicle (AOR 3.27; 95%CI 1.15-9.34. The risk of exercise-induced wheeze was related with postnatal SHS exposure (AOR 2.69; 95%CI 1.13-6.43.Conclusion: Respiratory symptoms were mostly affected by household smoking habits. Thus, in an attempt to reduce the repercussion of SHS exposure among younger adolescents, effort should be emphasized in encouraging parents to move from indoor to outdoor smoking far from the vicinity of children.Keywords: Passive smoking, Household smoking habits, Youth, Respiratory health, Hair nicotine 

  2. The association of respiratory symptoms and indoor housing conditions among migrant farmworkers in eastern North Carolina.

    Science.gov (United States)

    Kearney, Gregory D; Chatterjee, Arjun B; Talton, Jennifer; Chen, Haiying; Quandt, Sara A; Summers, Phillip; Arcury, Thomas A

    2014-01-01

    Farm labor housing has been described as among the worst in the nation, oftentimes with poor and unsanitary indoor living conditions. The objective of this study was to evaluate the association between indoor environmental risk factors and respiratory health among migrant farmworker occupants (N = 352) living in employer-provided housing. A cross-sectional sample of adult Latino male farm laborers were administered a questionnaire to identify the prevalence of major respiratory symptoms. Self-reported and independent observations were made to evaluate environmental respiratory risk factors and indoor housing conditions, including but not limited to, the presence of cockroaches, rodents, pesticides, and visible signs of mold. Spirometry was performed to evaluate lung function using FEV1 (forced expiratory volume in 1 second), FVC (forced vital capacity), and FEV1 /FVC ratio. Bivariate analysis was applied to evaluate associations between respiratory symptoms and selected indoor environmental risk factors. Findings for respiratory health included prevalence of wheeze (11.4%), coughing up phlegm (17.3%), tightness of chest (16.8%), and runny or stuffy nose (34.4%). Respiratory risks identified inside the dwellings included the use of pesticides or bug sprays for cockroaches (31.5%), rat or mouse poison (19.5%), visible signs of water damage in the bathroom (22.5%), and mold in the sleeping room (11.1%). Spirometry values were normal for most occupants, although statistically significant associations were found between mold and coughing up phlegm when not having a cold (P = .0262); presence of mold and asthma (P = .0084); pesticides used in the home and tightness of chest (P = .0001); and use of tobacco and coughing up phlegm (P = .0131). Although causal inference can be difficult to establish from a cross-sectional study, findings from this study represents suggestive evidence that indoor environmental risk factors may be contributory factors for respiratory health

  3. Reported respiratory symptom intensity in asthmatics during exposure to aerosolized Florida red tide toxins.

    Science.gov (United States)

    Milian, Alexyz; Nierenberg, Kate; Fleming, Lora E; Bean, Judy A; Wanner, Adam; Reich, Andrew; Backer, Lorraine C; Jayroe, David; Kirkpatrick, Barbara

    2007-09-01

    Florida red tides are naturally occurring blooms of the marine dinoflagellate, Karenia brevis. K. brevis produces natural toxins called brevetoxins. Brevetoxins become part of the marine aerosol as the fragile, unarmored cells are broken up by wave action. Inhalation of the aerosolized toxin results in upper and lower airway irritation. Symptoms of brevetoxin inhalation include: eye, nose, and throat irritation, coughing, wheezing, chest tightness, and shortness of breath. Asthmatics appear to be more sensitive to the effects of inhaled brevetoxin. This study examined data from 97 asthmatics exposed at the beach for 1 hour during K. brevis blooms, and on separate occasions when no bloom was present. In conjunction with extensive environmental monitoring, participants were evaluated utilizing questionnaires and pulmonary function testing before and after a 1-hour beach walk. A modified Likert scale was incorporated into the questionnaire to create respiratory symptom intensity scores for each individual pre- and post-beach walk. Exposure to Florida red tide significantly increased the reported intensity of respiratory symptoms; no significant changes were seen during an unexposed period. This is the first study to examine the intensity of reported respiratory symptoms in asthmatics after a 1-hour exposure to Florida red tide. PMID:17885863

  4. Cardio-respiratory symptoms in panic disorder: a contribution from cognitive-behaviour therapy

    Directory of Open Access Journals (Sweden)

    Anna Lucia Spear King

    2011-01-01

    Full Text Available Objective: To compare patients with panic disorder with agoraphobia treated with cognitive-behavioural therapy (CBT associated with the medication with patients treated only with medication and verify the behaviour of the cardio-respiratory symptoms of both groups. Methods: Randomized sample in the Psychiatry Institute of the Federal University of Rio de Janeiro, divided in two groups of 25 participants each. Group 1 undertook 10 weekly sessions of CBT with one hour of duration each together with medication. Group 2, Control, were administered medication that only consisted of tricyclic anti-depressants and selective inhibitors of the re-uptake of serotonin. Evaluation instruments were applied at the beginning and to the end of the interventions. Results: According to the applied scales, group 1 showed statistically more significant results than group 2, with: reduction of panic attacks, cardio-respiratory symptoms, anticipatory anxiety, agoraphobia avoidance and fear of bodily sensations. Conclusion: Exposures (in vivo and interoceptive, especially for induction symptom exercises and relaxation, were considered essential to prepare patients with panic disorder to handle future cardio-respiratory symptoms and panic attacks with agoraphobia.

  5. 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

  6. Household crowding, social mixing patterns and respiratory symptoms in seven countries of the African meningitis belt.

    Directory of Open Access Journals (Sweden)

    Claire F Ferraro

    Full Text Available OBJECTIVES: To describe the variation in household crowding and social mixing patterns in the African meningitis belt and to assess any association with self-reported recent respiratory symptoms. METHODS: In 2010, the African Meningococcal Carriage Consortium (MenAfriCar conducted cross-sectional surveys in urban and rural areas of seven countries. The number of household members, rooms per household, attendance at social gatherings and meeting places were recorded. Associations with self-reported recent respiratory symptoms were analysed by univariate and multivariate regression models. RESULTS: The geometric mean people per room ranged from 1.9 to 2.8 between Ghana and Ethiopia respectively. Attendance at different types of social gatherings was variable by country, ranging from 0.5 to 1.5 per week. Those who attended 3 or more different types of social gatherings a week (frequent mixers were more likely to be older, male (OR 1.27, p<0.001 and live in urban areas (OR 1.45, p<0.001. Frequent mixing and young age, but not increased household crowding, were associated with higher odds of self-reported respiratory symptoms (aOR 2.2, p<0.001 and OR 2.8, p<0.001 respectively. A limitation is that we did not measure school and workplace attendance. CONCLUSION: There are substantial variations in household crowding and social mixing patterns across the African meningitis belt. This study finds a clear association between age, increased social mixing and respiratory symptoms. It lays the foundation for designing and implementing more detailed studies of social contact patterns in this region.

  7. Fertilizer use and self-reported respiratory and dermal symptoms among tree planters.

    Science.gov (United States)

    Gorman Ng, Melanie; Stjernberg, Ernst; Koehoorn, Mieke; Demers, Paul A; Winters, Meghan; Davies, Hugh W

    2013-01-01

    In British Columbia, some tree planting operations require workers to fertilize planted seedlings with polymer-coated nitrogen, phosphorus, and potassium (NPK) fertilizers. This study examined respiratory and dermal health associated with fertilizer exposure among tree planters. We interviewed 223 tree planters using an adapted version of the American Thoracic Society questionnaire supplemented with questions on dermal health. Subjects were grouped by categories of increasing duration of exposure, with workers who had not worked with fertilizer as a reference group. The relationship between exposure and reported work-related symptoms was analyzed using logistic regression, adjusting for age, cumulative tobacco cigarettes smoked, marijuana smoking status, sex, and exposure to abrasive spruce needles. An elevated odds ratio was seen for work-related cough, phlegm, nasal symptoms, nosebleed, and skin rash in the highest exposure group (>37 days of fertilizer use in the past 2 years) but was significant only for phlegm (odds ratio = 3.59, 95% confidence interval = 1.10-11.70). Trends of increasing odds ratios with increasing exposure were seen for cough, phlegm, nasal symptoms, and skin rash. The results suggest a weak association between respiratory and dermal irritation and work with fertilizer. Results highlight the need for further exposure monitoring within the tree planting industry, and larger studies to investigate the relationship between work with fertilizer and respiratory and dermal health symptoms. [Supplementary materials are available for this article. Go to the publisher's online edition of the Journal of Occupational and Environmental Hygiene for the following free supplemental resource: a PDF file containing a respiratory and dermal health questionnaire.]. PMID:23194098

  8. Stability of respiratory symptoms in unlabelled wheezy illness and nocturnal cough.

    OpenAIRE

    Powell, C.V.; Primhak, R A

    1996-01-01

    OBJECTIVE: To assess the natural history of respiratory symptoms not labelled as asthma in primary schoolchildren. DESIGN: Repeat questionnaire survey of subgroups identified from a previous questionnaire survey after a two year delay. SUBJECTS: The original population of 5321 Sheffield children aged 8-9 years yielded 4406 completed questionnaires in 1991(82.8%). After excluding children with a label of asthma, there were 370 children with current wheeze, 129 children with frequent nocturnal ...

  9. 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

  10. Respiratory symptoms in rheumatoid arthritis. Relation between high resolution CT findings and functional impairment

    International Nuclear Information System (INIS)

    The objectives of this study were to analyze the high resolution computed tomography (HRCT) findings in rheumatoid arthritis (RA) patients with respiratory symptoms and to evaluate the relation between the extent of HRCT findings and functional impairment as assessed by spirometry. HRCT examination of the thorax and pulmonary function tests (PFTs) were performed in 34 RA patients with respiratory symptoms. Patients with smoking history or with emphysema evident on HRCT were excluded from the study. CT findings were assessed for the presence and pattern of abnormalities. Extent was scored based on the number of pulmonary segments involved. PFTs included forced expiratory flows (FEFs) and forced vital capacity (FVC). Bronchial wall thickening was detected in 29 of 34 RA patients (85%), small nodules in 24 patients (71%), and bronchial dilatation in 21 patients (62%). The extent of bronchial wall thickening correlated with FEF25-75, FEF75, and FEF50 (p<0.0001, respectively) (Spearman's rank correlation). Extent of small nodules correlated with FEF25-75, FEF50, and FEF25 (p<0.01, respectively). Stepwise regression analysis showed independent correlations of bronchial wall thickening with decreases in FEF25-75 and FEF75 (p<0.0001, both). Bronchial dilatation was also independently associated with a decrease in FVC (p<0.05). The most common HRCT findings in RA patients with respiratory symptoms are bronchial wall thickening and small nodules, and the extent of these findings correlates significantly with functional impairment. (author)

  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. Qigong Ameliorates Symptoms of Chronic Fatigue: A Pilot Uncontrolled Study

    Directory of Open Access Journals (Sweden)

    Naropa J. Mike Craske

    2009-01-01

    Full Text Available Traditional Chinese Medicine practitioners consider that chronic fatigue reflects a disharmony and depletion in the supply of qi in the body. Qigong is one of the traditional complementary interventions used to strengthen qi through self-practice, and to manage the state of qi to prevent and cure disease. The aim of this study is to assess whether qigong could be used to manage the symptoms of chronic fatigue. Eighteen Caucasian, British female participants were recruited, taught a qigong routine during weekly classes over 6 months, and asked to practice it daily for 15 min. Participants completed the core set of the RAND Medical Outcomes Study questionnaire (RAND MOS and a sleep diary during the 2-week baseline control period, and at 3 and 6 months following the start of the trial. The qigong intervention resulted in significant changes in sleep rate score and in the following subscales of the RAND MOS: SF36 Vitality, Sleep Problems, Social Activity, Social Activity Limitation due to Health, Health Distress, Mental Health Index and Psychological Well-being. Qigong seems to improve factors related to chronic fatigue such as sleep, pain, mental attitude and general mobility after 3 and 6 months. Qigong's positive effects indicate that it represents a potentially safe method of treatment for chronic fatigued patients. However, we cannot completely discount the possible influence of placebo effects, and more objective clinical measures are needed to reproduce our findings with long-term follow-up in a randomized, controlled study involving a larger number of subjects.

  13. 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...

  14. 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.

  15. 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

  16. Ozone-induced respiratory symptoms: exposure-response models and association with lung function

    Energy Technology Data Exchange (ETDEWEB)

    McDonnell, W.F. [NHEERL, US, Env. Protection Agency, Human Studies Division, RTP, NC (United States); Stewart, P.W. [Univ. of North Carolina, Dept. of Biostatistics, NC (United States); Smith, M.V. [MVS, Biomathematics, NC (United States); Pan, W.K. [Univ. of North Carolina, Dept. of Biostatistics, NC (United States); Pan, J. [Univ. of North Carolina, Dept. of Biostatistics, NC (United States)

    1999-07-01

    Ozone-induced respiratory symptoms are known to be functions of concentration, minute ventilation, and duration of exposure. The purposes of this study were to identify an exposure-response model for symptoms, to determine whether response was related to age, and to assess the relationships between symptom and lung function responses to ozone. Four hundred and eighty-five healthy male volunteers (ages 18 - 35 yrs) were exposed to one of six ozone concentrations at one of three activity levels for 2 hours. Symptoms and forced expiratory volume in one second (FEV1) were assessed at the end of 1 and 2 hours. The exposure and response data were fitted by a non-linear exposure-response model previously found to describe FEV1 response. The proportion of individuals experiencing moderate or severe cough, shortness of breath, and pain on deep inspiration were accurately described as functions of concentration, minute ventilation, and time. Response was inversely related to age for shortness of breath (p = 0.0001), pain on deep inspiration (p = 0.0002), and cough (p = 0.0013). Controlling for exposure differences, symptom responses were significantly but weakly (correlation coefficient 0.30 - 0.41) related to the FEV1 response. In conclusion, the exposure-response model did accurately predict symptoms, response was inversely related to age. (au)

  17. Lactobacillus fermentum (PCC®) supplementation and gastrointestinal and respiratory-tract illness symptoms: a randomised control trial in athletes

    OpenAIRE

    Hopkins William G; Cripps Allan W; Pyne David B; West Nicholas P; Eskesen Dorte C; Jairath Ashok; Christophersen Claus T; Conlon Michael A; Fricker Peter A

    2011-01-01

    Abstract Background Probiotics purportedly reduce symptoms of gastrointestinal and upper respiratory-tract illness by modulating commensal microflora. Preventing and reducing symptoms of respiratory and gastrointestinal illness are the primary reason that dietary supplementation with probiotics are becoming increasingly popular with healthy active individuals. There is a paucity of data regarding the effectiveness of probiotics in this cohort. The aim of this study was to evaluate the effecti...

  18. School absence and treatment in school children with respiratory symptoms in the Netherlands: Data from the Child Health Monitoring System

    OpenAIRE

    Spee-van der Wekke, J.; Meulmeester, J.F.; Radder, J.J.; Verloove-Vanhorick, S P

    1998-01-01

    STUDY OBJECTIVE: To assess the prevalence of respiratory problems, and the relation of these problems with school attendance, medicine use, and medical treatment. DESIGN: The Child Health Monitoring System. SETTING: Nineteen public health services across the Netherlands. PARTICIPANTS: 5186 school children aged 4-15 years, who were eligible for a routine health assessment in the 1991/1992 school year. MAIN RESULTS: Respiratory symptoms were present in 12% of the children. Recent symptoms...

  19. Community based study to compare the incidence and health services utilization pyramid for gastrointestinal, respiratory and dermal symptoms

    Directory of Open Access Journals (Sweden)

    Najnin Nusrat

    2012-07-01

    Full Text Available Abstract Background Gastrointestinal (GI, respiratory and dermal symptoms are common and cause substantial morbidity, although the information on their exact incidence and comparative burden is limited. The aim of this study was to describe the epidemiology and rate these three major symptom complexes in order to improve our understanding of the health burden imposed by these symptoms. Methods We used data from a community based randomised control trial conducted from June 2007 to August 2008 among 277 South Australian families consuming rainwater. Using weekly health diaries, we prospectively collected information on GI (diarrhoea or vomiting, respiratory (sore throat, runny nose or cough and dermal (rash, generalised itch or dermal infection symptoms, as well as on relevant GP visits, time off work and/or hospitalisation due to these symptoms. Data were analysed using generalized estimating equations approach taking into account the variable number of weeks of follow-up of each individual and within-family clustering of responses. Results Over one year, at least one episode of GI symptoms was reported by 54% of participants (95% CI 50%-58%, at least one respiratory episode by 91% (95% CI 88%-93% and at least one episode of dermal symptoms by 27% (95% CI 24%-30%. The average number of weeks per year during which respiratory symptoms occurred was four times greater than for GI or dermal symptoms (4.9, 1.2 and 1.2 weeks, respectively, p Conclusions This first comparative study of three different symptom complexes showed that although respiratory symptoms are most common, GI symptoms cause a greater per episode burden on healthcare resources. Measuring and comparing the community based burden of these symptom complexes will assist evidence-based allocation of resources.

  20. Tracheal diverticulum: an unusual cause of chronic cough and recurrent respiratory infections.

    Science.gov (United States)

    Takhar, Rajendra Prasad; Bunkar, Motilal; Jain, Shubhra; Ghabale, Sanjay

    2016-03-01

    Tracheal diverticulum (TD) defined as a typical benign out-pouching of the tracheal wall due to structural weakness, congenital or acquired in origin, resulting in paratracheal air cysts. It is rarely diagnosed in clinical practice with only limited reports in the literature. Most cases found incidentally in the postmortem examination and located on the right side. Uncomplicated TDs are usually asymptomatic and when symptoms have occurred, they usually present with non-specific symptoms like pharyngeal discomfort, cough, dyspnea, and recurrent respiratory infection due to either the compression of adjacent organs or secondary bacterial infection. Imaging techniques like thoraco-cervical multi-slice spiral computed tomography (CT) and fiber-optic bronchoscopy are important diagnostic tools for this entity. Asymptomatic TDs usually require no treatment and managed conservatively while surgical excision is indicated in cases of compression of adjacent organs and recurrent infections. Here we report a case of tracheal diverticulum on the left side, which was diagnosed as part of a work-up for chronic cough and recurrent chest infection in a 40 year old female who was already on bronchodilator without any relief. Diagnosis of TD was based on findings of computed tomography, revealing small bud like projection on left para tracheal region and further confirmed by fiber-optic bronchoscopy while the barium contrast study showed no esophageal communication. She was managed conservatively and referred for surgical excision. PMID:27266290

  1. Respiratory virus infection as a cause of prolonged symptoms in acute otitis media.

    Science.gov (United States)

    Arola, M; Ziegler, T; Ruuskanen, O

    1990-05-01

    We studied respiratory viruses in 22 children with acute otitis media who had failed to improve after at least 48 hours of antimicrobial therapy. The mean duration of preenrollment antimicrobial therapy was 4.8 days. For comparison we studied 66 children with newly diagnosed acute otitis media. Respiratory viruses were isolated from middle ear fluid or from the nasopharynx, or both, significantly more often in the patients unresponsive to initial antimicrobial therapy than in the comparison patients (68% vs 41%, p less than 0.05). Viruses were recovered from the middle ear fluid in 32% of the study patients and from 15% of the comparison group. Bacteria were isolated from the middle ear fluid of four (18%) children in the study group; one child had an isolate resistant to initial antimicrobial therapy. All four children with bacteria in the middle ear fluid had evidence of concomitant respiratory virus infection. Our results indicate that respiratory virus infection is often present in patients with acute otitis media unresponsive to initial antimicrobial therapy, and may explain the prolongation of symptoms of infection. Resistant bacteria seem to be a less common cause of failure of the initial treatment.

  2. Acute respiratory symptoms and general illness during the first year of life: a population-based birth cohort study

    DEFF Research Database (Denmark)

    von Linstow, Marie-Louise; Holst, Klaus Kähler; Larsen, Karina;

    2008-01-01

    Respiratory symptoms are common in infancy. Most illnesses occurring among children are dealt with by parents and do not require medical attention. Nevertheless, few studies have prospectively and on a community-basis assessed the amount of respiratory symptoms and general illness in normal infants...... out by multiple logistic regression analysis. On average, children had general symptoms for 3.5 months during their first year of life, nasal discharge being most frequent followed by cough. Frequency of all symptoms increased steeply after 6 months of age. Each child had on average 6.3 episodes...... (median: 5.1, inter-quartile range (IQR): 3.3-7.8) of acute respiratory tract illness (ARTI) (nasal discharge and > or = 1 of the following symptoms: cough, fever, wheezing, tachypnea, malaise, or lost appetite) and 5.6 episodes (median: 4.3, IQR: 2.1-7.3) of simple rhinitis per 365 days at risk...

  3. Respiratory rehabilitation: a physiotherapy approach to the control of asthma symptoms and anxiety

    Directory of Open Access Journals (Sweden)

    Renata André Laurino

    2012-11-01

    Full Text Available OBJECTIVES: The objectives of this study were to verify the degree of anxiety, respiratory distress, and health-related quality of life in a group of asthmatic patients who have experienced previous panic attacks. Additionally, we evaluated if a respiratory physiotherapy program (breathing retraining improved both asthma and panic disorder symptoms, resulting in an improvement in the health-related quality of life of asthmatics. METHODS: Asthmatic individuals were assigned to a chest physiotherapy group that included a breathing retraining program held once a week for three months or a paired control group that included a Subtle Touch program. All patients were assessed using the Diagnostic and Statistical Manual of Mental Disorders IV, the Sheehan Anxiety Scale, the Quality of Life Questionnaire, and spirometry parameter measurements. RESULTS: Both groups had high marks for panic disorder and agoraphobia, which limited their quality of life. The Breathing Retraining Group program improved the clinical control of asthma, reduced panic symptoms and agoraphobia, decreased patient scores on the Sheehan Anxiety Scale, and improved their quality of life. Spirometry parameters were unchanged. CONCLUSION: Breathing retraining improves the clinical control of asthma and anxiety symptoms and the health-related quality of life in asthmatic patients.

  4. Presence of Recurrent Airway Obstruction in a Group of Colombian Native Horses with Respiratory Symptoms

    Directory of Open Access Journals (Sweden)

    Cristian Alejandro Castillo Franz

    2013-12-01

    Full Text Available The purpose of this study was to determine the presence of recurrent airway obstruction (RAO through bronchoalveolar lavage (BAL in a group of twenty Colombian native horses with respiratory symptoms. Each animal underwent a clinical examination in order to corroborate the respiratory disturbance and later perform the BAL. The results obtained showed that 65% of the animals under study tested positive for RAO, based on the clinical and BAL results, and that, among the total number of animals that tested positive, 61.5% suffered a severe form of such condition. We also found an association between the number of neutrophils and the color of the BAL fluid, and an inverse relationship between cell cytology of macrophages and neutrophils. It is concluded that the Colombian native horse, like other horse breeds, suffers from RAO, sometimes severely, related to predisposing factors such as accommodation and stabling.

  5. Residential proximity to major roadways is associated with increased prevalence of allergic respiratory symptoms in children

    Directory of Open Access Journals (Sweden)

    Gregor Porebski

    2014-11-01

    Full Text Available [b]introduction and objective[/b]. Numerous epidemiologic studies have reported increased risk of allergic rhinitis and asthma in relation to ‘western life-style’, which represents diversity of factors. We hypothesized that residential proximity to major roadways, reflecting an exposure to traffic-related air pollution, is associated with prevalence of allergic respiratory symptoms in children. [b]materials and methods[/b]. A total of 8290 individuals of two age groups: 16 year olds and 7 year olds from Krakow, Poland were included. We used the Polish version of the International Study of Asthma and Allergy in Childhood supplemented with a question concerning the distance between a responder’s house and a high traffic density road: below 200 m, from 200–500 m, or more than 500 m. [b]results[/b]. Children and adolescents with a residential proximity closer to a major roadway had more frequent asthma-related symptoms in the last 12 months and at any time in the past. Consistent with the increased frequency of asthmatic symptoms, responders residing within 200 meters complained more often of sneezing, runny or blocked nose accompanied by itchy-watery eyes and hay fever in comparison to responders who resided 200–500 meters from a major roadway. The lowest rate of nasal symptoms was observed in residents living in the distance to major roads (> 500 meters. The rate of positive answers decreased in a distant-dependent manner. [b]conclusions[/b]. Our findings suggest an important spatial relationship between the distance from a major roadway and the evaluated respiratory symptoms. The results emphasize the need for more comprehensive air quality policies within urban areas with increased motor vehicle density.

  6. Respiratory and ocular symptoms among employees of a hotel indoor waterpark resort--Ohio, 2007.

    Science.gov (United States)

    2009-02-01

    During January--March 2007, the Warren County Combined Health District (WCCHD) received 665 reports of respiratory and eye irritation from patrons and lifeguards at a hotel indoor waterpark resort in Ohio. Tests revealed normal water chemistry and air chlorine concentrations, and exposure to airborne trichloramine in the waterpark was suspected as the cause of the symptoms. Because of the number of symptom reports and WCCHD's limited ability to measure trichloramine, the district requested an investigation by CDC's National Institute for Occupational Safety and Health (NIOSH). This report describes the results of that investigation, which revealed that trichloramine concentrations in the waterpark ranged from below the limit of detection to 1.06 mg/m3, and some concentrations were at levels that have been reported to cause irritation symptoms (>/=0.5 mg/m3). Lifeguards reported significantly more work-related symptoms (e.g., cough, wheezing, shortness of breath, chest tightness, and eye irritation) than unexposed hotel employees. Lifeguards also reported significantly more eye irritation and cough on days when hotel occupancy was high versus low. Insufficient air movement and distribution likely led to accumulation of trichloramine and exacerbation of symptoms. Based on recommendations to increase air movement and distribution at pool deck level, hotel management modified the ventilation system extensively, and subsequently no new cases were reported to WCCHD. The results of this investigation emphasize the importance of appropriate design and monitoring of ventilation and water systems in preventing illness in indoor waterparks. PMID:19194369

  7. 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...

  8. Respiratory symptoms and annoyance in the vicinity of coal-fired plants.

    OpenAIRE

    Pershagen, G; Hammar, N; Vartiainen, E.

    1986-01-01

    This study constitutes one part of a program for assessing the impact of coal-fired power plants on the surrounding communities. A questionnaire was mailed to a total of 12,000 subjects living in six areas with coal-fired plants and in matched reference areas. The participation rate was 77.3%. In one coal-fired plant/reference area pair, a more detailed medical examination was carried out among subjects who reported symptoms of the respiratory tract. The match between coal-fired plant and ref...

  9. Prevalence of Asthma and Respiratory Symptoms among University Students in Sari (North of Iran)

    Science.gov (United States)

    Parsi, Behzad; Shahabi Majd, Naghi

    2016-01-01

    Background: Despite widely available data about childhood asthma, there are limited data about the prevalence of asthma among young adults in Iran. The aim of this study was to determine the prevalence of asthma and respiratory symptoms among medical students in the city of Sari in Northern Iran. Materials and Methods: The prevalence of asthma and respiratory symptoms was studied using a standard questionnaire. Based on the information obtained from the questionnaires, the study participants were divided into two groups of asthmatics and non-asthmatics. Pulmonary function tests including forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) before, and after salbutamol inhalation were measured in all subjects with asthma and approximately 10% of those without asthma. Results: A total of 1,011 subjects (374 males, 637 females) participated in this study. Asthma was found in 3.5% of the subjects (3.2% males and 3.6% females). The 12-month prevalence of wheezing, coughing at rest, coughing at night, breathlessness at rest, exercise-induced wheezing, and exercise-induced coughing in the entire study population was 11.1%, 12.4%, 13.4%, 13.3%, 17.7%, and 16.7%, respectively. The prevalence of all asthma-related symptoms was significantly higher among asthmatics compared to non-asthmatics. Moreover, asthmatic subjects showed lower FEV1 and FVC values compared to nonasthmatic subjects (P<0.001). Smoking and family history of asthma were statistically significant risk factors for developing asthma. Conclusion: The high prevalence of asthma related symptoms in the present study strongly suggests that asthma is under diagnosed and under treated among participants.

  10. Respiratory symptoms in Danish farmers: an epidemiological study of risk factors.

    Science.gov (United States)

    Iversen, M; Dahl, R; Korsgaard, J; Hallas, T; Jensen, E J

    1988-01-01

    An epidemiological study was performed with a self administered questionnaire in a representative sample of 1685 Danish farmers. The purpose of the study was to assess the prevalence of self reported asthma, wheezing during work, and symptoms of chronic bronchitis and to evaluate possible risk factors for the development of these symptoms. A response rate of 73.3% was obtained. The prevalence of asthma was 7.7% and of chronic bronchitis 23.6% in responders. The prevalence of asthma and chronic bronchitis increased from 3.6% and 17.9% in 31-50 year old farmers to 11.8% and 33.0% in 51-70 year old farmers, and from 5.5% and 17.5% in dairy farmers to 10.9% and 32.0% in pig farmers. A logistic regression analysis with correction for age and smoking habits confirmed that pig farming was a risk factor for asthma (odds ratio 2.03), chronic bronchitis (odds ratio 1.53), and wheezing during work (odds ratio 3.33). PMID:3222758

  11. 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 ...

  12. Codevelopment of externalizing and internalizing symptoms in middle to late childhood: Sex, baseline respiratory sinus arrhythmia, and respiratory sinus arrhythmia reactivity as predictors

    OpenAIRE

    Hinnant, J. Benjamin; El-Sheikh, Mona

    2013-01-01

    We investigated the roles of sex and respiratory sinus arrhythmia (RSA), an index of autonomic parasympathetic nervous system activity, as predictors of codeveloping externalizing and internalizing symptoms in middle childhood. We expected that sex, baseline RSA (RSA-B), and RSA reactivity (RSA-R) to two types of tasks would interact to differentiate co-occurring trajectories of symptoms. We tested these hypotheses by combining longitudinal data from two independent samples (n = 390; 210 girl...

  13. Indoor air quality in schools and its relationship with children's respiratory symptoms

    Science.gov (United States)

    Madureira, Joana; Paciência, Inês; Rufo, João; Ramos, Elisabete; Barros, Henrique; Teixeira, João Paulo; de Oliveira Fernandes, Eduardo

    2015-10-01

    A cross-sectional survey was conducted to characterize the indoor air quality (IAQ) in schools and its relationship with children's respiratory symptoms. Concentrations of volatile organic compounds (VOC), aldehydes, PM2.5, PM10, carbon dioxide, bacteria and fungi were assessed in 73 classrooms from 20 public primary schools located in Porto, Portugal. Children who attended the selected classrooms (n = 1134) were evaluated by a standardised health questionnaire completed by the legal guardians; spirometry and exhaled nitric oxide tests. The results indicated that no classrooms presented individual VOC pollutant concentrations higher than the WHO IAQ guidelines or by INDEX recommendations; while PM2.5, PM10 and bacteria levels exceeded the WHO air quality guidelines or national limit values. High levels of total VOC, acetaldehyde, PM2.5 and PM10 were associated with higher odds of wheezing in children. Thus, indoor air pollutants, some even at low exposure levels, were related with the development of respiratory symptoms. The results pointed out that it is crucial to take into account the unique characteristics of the public primary schools, to develop appropriate control strategies in order to reduce the exposure to indoor air pollutants and, therefore, to minimize the adverse health effects.

  14. Diarrhea and respiratory symptoms among travelers to Asia, Africa, and South and Central America from Scotland.

    Science.gov (United States)

    Redman, Christopher Allan; Maclennan, Alice; Wilson, Eleanor; Walker, Eric

    2006-01-01

    Surveillance using admissions to hospital, while being useful, is a poor indicator of the real incidence of disease encountered by travelers. An alternative is self-reported illness among those who attended at a pretravel clinic prior to their travels. Estimates of incidence and risk factors were determined for attendees at a travel clinic in Scotland using a questionnaire. Analysis for risk factors was carried out for those travelers visiting countries in Africa, Asia, or South and Central America, who had traveled for 1 week or more and had returned between 1997 and 2001 (N= 4,856). Multivariate logistic regression was used to test the hypotheses that time abroad and age-group would be significant for both respiratory and diarrheal symptoms regardless of which of the three geographical areas are visited. From 2006 returned questionnaires (response rate = 41.3%), diarrhea and respiratory symptoms were reported by 44.2 and 16.8% of respondents, respectively; the incidence was significantly greater among travelers to Asia for both diarrheal (55.5%) and respiratory (23.7%) symptoms than among travelers to Africa (36.6 and 12.2%, respectively) or South and Central America (39.5 and 16.2%, respectively). For diarrhea, age was a highly significant risk factor for travelers to Asia, South and Central America, and Africa. Being a self-organized tourist/backpacker, traveling to Asia was associated with increased risk, while for Africa and South and Central America visiting family or friends was associated with a lower risk. For travelers to Asia, traveling to the Indian subcontinent was significantly associated with increased risk. The majority of travelers had an adverse event while traveling abroad, with diarrhea and respiratory conditions being especially common despite attending a travel clinic for advice prior to departure. However, the limitations of this surveillance-based strategy have highlighted the requirement for more research to understand more fully the

  15. 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...

  16. Postconcussion Symptoms in Patients with Injury-Related Chronic Pain

    Directory of Open Access Journals (Sweden)

    Britt Marie Stålnacke

    2012-01-01

    Full Text Available Background. Postconcussion symptoms (PCSs—such as fatigue, headache, irritability, dizziness, and impaired memory—are commonly reported in patients who have mild traumatic brain injuries (MTBIs. Evaluation of PCS after MTBI is proposed to have a diagnostic value although it is unclear whether PCS are specific to MTBI. After whiplash injuries, patients most often complain of headaches and neck pain; the other PCS are not as closely evaluated. In patients with chronic pain because of other injuries, the presence of PCS is unclear. This study aimed to describe the frequency of PCS in patients with injury-related pain and to examine the relationships between PCS, pain, and psychological factors. Methods. This study collected data using questionnaires addressing PCS (Rivermead Postconcussion Questionnaire, RPQ, pain intensity (Visual Analogue Scale, depression, anxiety (Hospital, Anxiety, and Depression Scale, and posttraumatic stress (Impact of Event Scale. Results. Fatigue (90.7%, sleep disturbance (84.9%, headache (73.5%, poor concentration (88.2%, and poor memory (67.1% were some of the most commonly reported PCS. Significant relationships were found between PCS and posttraumatic stress, depression, and anxiety. Conclusion. To optimize treatment, it is important to assess each patient’s PCS, the mechanism of injury, and factors such as posttraumatic stress and depression.

  17. Self-reported symptoms of chronic cough and breathlessness in working-age men in the city of Izhevsk, Russia: associations with cardiovascular disease risk factors and comorbidities

    Science.gov (United States)

    Cook, Sarah; Quint, Jennifer K; Vasiljev, Maxim; Leon, David A

    2015-01-01

    Introduction Very little is known about the prevalence of respiratory symptoms or their associations with other health conditions in Russia. Methods Between 2008 and 2010, a sample of 983 men resident in Izhevsk, Russia, took part in a cross-sectional survey. Presence of respiratory symptoms was determined from self-report of chronic productive cough and breathlessness assessed using the British Medical Research Council (MRC) breathlessness scale. Self-reported physical and mental health were measured using the 12-Item Short-Form Health Survey (SF-12). Hypertension was assessed from mean blood pressure measured at the health check and/or self-reported use of antihypertensive medication. Other comorbidities were assessed from self-report. Logistic regression models were fitted assessing the association between respiratory symptoms and comorbidities. Linear regression models were fitted to investigate the association between respiratory symptoms and self-reported health scores. All models were adjusted for age, education and smoking status. Results The age-standardised prevalence of cough and breathlessness was 20.9% (prevalence with breathlessness MRC grade 3 or above 3.7%). The majority of men with respiratory symptoms (87.3%) were current smokers. Cough and breathlessness were associated with substantially worse self-reported physical and mental health (test for trend with severity of breathlessness p<0.001). Those with chronic cough and grade 3 or above breathlessness had higher odds of having hypertension (OR 3.03; 95% CI 1.36 to 6.74), diabetes (OR 10.55; 95% CI 2.69 to 41.37), angina pectoris (OR 7.54; 95% CI 3.61 to 15.73), previous myocardial infarction (OR 7.61; 95% CI 2.10 to 27.4) and previous stroke (OR 6.61; 95% CI 1.75 to 23.34) compared with those without respiratory symptoms. Conclusions The prevalence of respiratory symptoms was high. Strong associations were found between respiratory symptoms and cardiovascular comorbidities. These are of

  18. Respiratory symptoms among infants at risk for asthma: association with surfactant protein A haplotypes

    Directory of Open Access Journals (Sweden)

    Bracken Michael B

    2007-04-01

    Full Text Available Abstract Background We examined the association between single nucleotide polymorphisms (SNPs in loci encoding surfactant protein A (SFTPA and risk of wheeze and persistent cough during the first year of life among a cohort of infants at risk for developing asthma. Methods Between September 1996 and December 1998, mothers of newborn infants were invited to participate if they had an older child with clinician-diagnosed asthma. Each mother was given a standardized questionnaire within 4 months of her infant's birth. Infant respiratory symptoms were collected during quarterly telephone interviews at 6, 9 and 12 months of age. Due to the association of SFTPA polymorphisms and race/ethnicity, analyses were restricted to 221 white infants for whom whole blood and respiratory data were available. Ordered logistic regression models were used to examine the association between respiratory symptom frequency and SFTPA haplotypes. Results The 6A allele haplotype of SFTPA1, with an estimated frequency of 6% among our study infants, was associated with an increased risk of persistent cough (OR 3.69, 95% CI 1.71, 7.98 and wheeze (OR 4.72, 95% CI 2.20, 10.11. The 6A/1A haplotype of SFTPA, found among approximately 5% of the infants, was associated with an increased risk of persistent cough (OR 3.20, 95% CI 1.39, 7.36 and wheeze (OR 3.25, 95% CI 1.43, 7.37. Conclusion Polymorphisms within SFTPA loci may be associated with wheeze and persistent cough in white infants at risk for asthma. These associations require replication and exploration in other ethnic/racial groups.

  19. 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.

  20. Correlation of respiratory symptoms and spirometric lung patterns in a rural community setting, Sindh, Pakistan: a cross sectional survey

    Directory of Open Access Journals (Sweden)

    Abbasi Imran Naeem

    2012-12-01

    Full Text Available Abstract Background Symptom-based questionnaires can be a cost effective tool enabling identification and diagnosis of patients with respiratory illnesses in resource limited setting. This study aimed to determine the correlation of respiratory symptoms and spirometric lung patterns and validity of ATS respiratory questionnaire in a rural community setting. Methods This cross sectional survey was conducted between January – March 2009 on a sample of 200 adults selected from two villages of district Khairpur, Sindh, Pakistan. A modified version of the American thoracic society division of lung disease questionnaire was used to record the presence of respiratory symptoms. Predicted lung volumes i.e. forced vital capacity (FVC, forced expiratory volume in one second (FEV1 and their ratio (FEV1/FVC were recorded using portable spirometer. Results In the study sample there were 91 (45.5% males and 109 (54.5% females with overall mean age of 34 years (±11.69. Predominant respiratory symptom was phlegm (19% followed by cough (17.5%, wheeze (14% and dyspnea (10.5%. Prevalence of physician diagnosed and self-reported asthma was 5.5% and 9.5% respectively. Frequency of obstructive pattern on spirometry was 28.72% and that of restrictive pattern was 19.68%. After adjustment for age, gender, socioeconomic status, spoken dialect, education, smoking status, height, weight and arsenic in drinking water, FVC was significantly reduced for phlegm (OR 3.01; 95% CI: 1.14 – 7.94, wheeze (OR 7.22; 95% CI: 2.52 – 20.67 and shortness of breath (OR 4.91; 95% CI: 1.57 – 15.36; and FEV1 was significantly reduced for cough (OR 2.69; 95% CI: 1.12 – 6.43, phlegm (OR 3.01; 95% CI: 1.26 – 7.16 and wheeze (OR 10.77; 95% CI: 3.45 – 33.6. Presence of respiratory symptoms was significantly associated with restrictive and/or obstructive patterns after controlling for confounders. Similar findings were observed through linear regression where respiratory symptoms were

  1. Identification of cross-reactive carbohydrate determinants in subjects reporting work-related respiratory symptoms

    Directory of Open Access Journals (Sweden)

    Marta Wiszniewska

    2015-02-01

    Full Text Available Introduction The role of cross-reactive carbohydrate determinants (CCDs in diagnostics of occupational allergy remains unclarified and its clinical relevance is still questioned. The aim of the study was to assess the frequency of positive response to CCDs in the subjects with suspected occupational allergy and the relationship between other diagnostic test results and final diagnosis. Material and methods The study group included 201 patients. They underwent clinical examination, skin prick test (SPT to common and occupational allergens, specific serum immunoglobulin (sIgE determinations, spirometry and specific inhalation challenge test. Moreover, sIgE to CCDs from bromelain was assessed in all subjects. Results Occupational respiratory allergy was recognized in 64.3% of CCD-positive and 52.4% of CCD-negative patients. Positive SPT results to common and occupational allergens were found in 64.3% and 35.7% of CCD-positive subjects, respectively. In all subjects with CCDs, the sIgE to grass pollens as well as to occupational allergens were detected. The total IgE level > 100 kU/l was significantly associated with the presence of sIgE to CCDs. Conclusions sIgE to CCDs were found in 7% of subjects suspected to suffer from occupational respiratory allergy. The presence of CCDs is not significantly associated with occupational respiratory allergy. It is also not more frequent in subjects reporting work-related respiratory symptoms in whom occupational allergy was not confirmed. The elevated total IgE level was related with CCD positivity. In patients with suspected occupational allergy, the presence of sIgE to CCDs in serum did not indicate the irrelevance of positive sIgE to occupational allergens.

  2. Respiratory symptoms in households as an effective marker for influenza-like illness surveillance in the community.

    Science.gov (United States)

    Lee, Shui Shan; Wong, Ngai Sze

    2014-06-01

    To effectively track the growth of influenza, we piloted an online system to monitor influenza-like illness (ILI) in the community in one district of Hong Kong. Four syndromic markers, namely fever, respiratory symptoms, fever with respiratory symptoms, fever and/or respiratory symptoms, either of the individual or of the household, were collected during the study period from June 2012 to October 2013. A total of 132 residents of Tuen Mun District reported syndromic markers at the individual and household levels on a weekly basis. Temporal patterns of these markers were compared with data derived from laboratory surveillance by dynamic linear regression. Household respiratory symptoms were found to be an effective syndromic marker, pre-dating overall laboratory virus surveillance results on influenza diseases in two influenza seasons by 3-4 weeks. To conclude, respiratory symptoms can be a good marker predicting the onset of the influenza season in the community, and is particularly useful with regard to data from households, even if the sample size may not be a large one. PMID:24680819

  3. 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.

  4. Glucose Metabolism Disorder Is Associated with Pulmonary Tuberculosis in Individuals with Respiratory Symptoms from Brazil

    Science.gov (United States)

    Castro, Simone; Cafezeiro, Aparecida S.; Daltro, Carla; Netto, Eduardo M.; Kornfeld, Hardy; Andrade, Bruno B.

    2016-01-01

    Background Diabetes mellitus (DM) has been associated with increased risk for pulmonary tuberculosis (PTB) in endemic settings but it is unknown whether PTB risk is also increased by pre-DM. Here, we prospectively examined the association between glucose metabolism disorder (GMD) and PTB in patients with respiratory symptoms at a tuberculosis primary care reference center in Brazil. Methods Oral glucose tolerance test was performed and levels of fasting plasma glucose and glycohemoglobin (HbA1c) were measured in a cohort of 892 individuals presenting with respiratory symptoms of more than two weeks duration. Patients were also tested for PTB with sputum cultures. Prevalence of pre-DM and DM (based on HbA1c) was estimated and tested for association with incident PTB. Other TB risk factors including smoking history were analyzed. Results The majority of the study population (63.1%) exhibited GMD based on HbA1c ≥5.7%. Patients with GMD had higher prevalence of PTB compared to normoglycemic patients. Individuals with DM exhibited increased frequency of TB-related symptoms and detection of acid-fast bacilli in sputum smears. Among patients with previous DM diagnosis, sustained hyperglycemia (HbA1c ≥7.0%) was associated with increased TB prevalence. Smoking history alone was not significantly associated with TB in our study population but the combination of smoking and HbA1c ≥7.0% was associated with 6 times higher odds for PTB. Conclusions Sustained hyperglycemia and pre-DM are independently associated with active PTB. This evidence raises the question whether improving glycemic control in diabetic TB patients would reduce the risk of TB transmission and simultaneously reduce the clinical burden of disease. A better understanding of mechanisms underlying these associations, especially those suggesting that pre-DM may be a factor driving susceptibility to TB is warranted. PMID:27078026

  5. 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...

  6. Fluoxetine ameliorates symptoms of refractory chronic prostatitis/chronic pelvic pain syndrome

    Institute of Scientific and Technical Information of China (English)

    XIA Dan; WANG Ping; CHEN Jun; WANG Shuo; JIANG Hai

    2011-01-01

    Background Category Ⅲ chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a common syndrome of unclear etiology with significant impact on quality of life. Because the outcomes of multiple therapies for CP/CPPS have been far from approving, the possible psychological factors have been considered to play an important role in CP/CPPS.Based on this, we investigated the role of antidepressant drug (fluoxetine) in men with refractory CP/CPPS.Methods In this study, 42 men diagnosed with refractory CP/CPPS without response to standard therapy (include multiple antibiotic courses and a-blockers) were referred for fluoxetine therapy. All patients received fluoxetine (20 mg/d) for three months and were clinically evaluated before (baseline), and after 4, 8 and 12 weeks of therapy. The evaluation included a National Institutes of Health-chronic prostatitis symptom index (NIH-CPSI) and a Beck depression inventory (BDI) questionnaire. Moreover, the subjective global assessment (SGA) was assessed at the 4th, 8th and 12th week of therapy.Results Significant decreases were observed for total NIH-CPSI (28.55 to 9.29), NIH-CPSI pain (14.69 to 5.19),NIH-CPSI urinary (4.95 to 1.88 ), NIH-CPSI quality of life (8.83 to 2.20), and BDI (34.67 to 13.95) scores compared with baseline, all P values <0.05. Twenty-nine (69.05%) reported marked improvement on the subjective global assessment and 33 (78.57%) had a greater than 50% decrease in NIH-CPSI at the end of therapy (12th week). At the same time, the Pearson correlation coefficient analysis demonstrated a positive correlation between BDI score and each CPSI score. No adverse events were reported in this study.Conclusions Fluoxetine appears to be a safe and effective treatment in improving symptoms in, and the quality of life of, men with difficult CP/CPPS. Moreover, amelioration of difficult CP/CPPS-related symptoms could be related to a decrease in depressive symptoms.

  7. [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.

  8. A study of New Zealand wood workers: exposure to wood dust, respiratory symptoms, and suspected cases of occupational asthma.

    Science.gov (United States)

    Norrish, A E; Beasley, R; Hodgkinson, E J; Pearce, N

    1992-05-27

    A randomly selected group of 50 New Zealand wood workers was studied. The level of airborne wood dust to which they were exposed ranged from 1.0-24.5 mg/m3. The wood workers reported experiencing higher rates of both lower and upper respiratory tract symptoms than a control group of office workers. Inhaled wood dust, in particular from rimu (Dacrydium cupressinum), was frequently cited by workers as being associated with respiratory tract symptoms. The wood workers' responses to the respiratory symptom questionnaire, and serial recordings of peak expiratory flow rate were used to screen the group for suspected cases of occupational asthma. Five cases fulfilled the study's criteria for suspected occupational asthma. In four of these, further evidence was found to support this diagnosis. We conclude that exposure to wood dust may cause occupational asthma in the woodworking industry in New Zealand.

  9. Focused Sonographic Examination of the Heart, Lungs and Deep Veins in Acute Admitted Patients with Respiratory Symptoms

    DEFF Research Database (Denmark)

    Laursen, Christian Borbjerg; Sloth, Erik; Lassen, Annmarie Touborg;

    2012-01-01

    the use of sonographic examination of the heart, lungs and deep veins, performed within one hour of the primary evaluation, in acute admitted patients with respiratory symptoms. Methods: We performed a prospective cross sectional blinded observational study, conducted in a medical emergency department....... Patients were included if one or more of the following symptoms or clinical findings were present: respiratory rate > 20, saturation lungs and deep veins...... with pulmonary oedema, 1 had pericardial effusion, 1 had massive pleural effusion, 5 had empyema and 4 had pulmonary embolism. Conclusion: Focused sonography of the heart, lungs and deep veins is a highly feasible and non-invasive bedside method. In acute admitted patients with respiratory symptoms, it may help...

  10. Smoking, respiratory symptoms and likely asthma in young people: evidence from postal questionnaire surveys in the Wythenshawe Community Asthma Project (WYCAP

    Directory of Open Access Journals (Sweden)

    Linehan Mary

    2006-05-01

    Full Text Available Abstract Background Although it is recognised that smoking is a major risk factor for subjects with chronic obstructive pulmonary disease and is associated with respiratory symptoms, there is less agreement concerning the relationship between asthma and smoking. This study aims to examine the relationship between cigarette smoking and asthma prevalence. Method Data were used from two postal questionnaire surveys (1999 and 2001 in two general practice populations, using a respiratory questionnaire based on the ECRHQ and a generic quality of life questionnaire (EQ-5D. Only subjects less than 45 years old were included in the survey. An empirical definition of likely asthma was used based on respiratory questionnaire responses. Smoking was examined according to three categories, current smoker, ex smoker and never smoker. Results Almost 3500 subjects were included in the analyses. Current smokers had a higher prevalence of likely asthma compared to never smokers, odds ratio (OR 1.59 (95% confidence interval (CI 1.24 to 2.04. and also compared to ex smokers OR 1.79 (CI 1.25 to 2.56, but there was no difference between ex smokers and never smokers (OR 1.00 (0.75–1.35. Current smoking was also positively associated with all symptoms but not with a history of hayfever/eczema. Conclusion Although the positive association found between current smoking and obstructive airways disease is likely to be due to the effect of cigarettes on asthma, it could reflect an association with early COPD (GOLD stages 0 or 1. Smoking cessation has a beneficial effect on the prevalence of respiratory symptoms and is therefore of paramount importance among these young adults.

  11. 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...

  12. Nutritional deficits in elderly smokers with respiratory symptoms that do not fulfill the criteria for COPD

    Directory of Open Access Journals (Sweden)

    Obase Y

    2011-12-01

    Full Text Available Yasushi Obase1, Keiji Mouri1, Hiroki Shimizu1, Yoshihiro Ohue1, Yoshihiro Kobashi1, Kazue Kawahara2, Mikio Oka11Department of Respiratory Medicine, Kawasaki Medical School, 2Department of Clinical Nutrition, Faculty of Health Science and Technology, Kawasaki University of Medical Welfare, Kurashiki, Okayama, JapanBackground and objective: Whereas nutrition deficits are recognized as an expression of systemic inflammation in the elderly with diagnosed chronic obstructive pulmonary disease (COPD, if they occur in symptomatic elderly smokers, unfulfilled COPD criteria are not confirmed.Methods: Respiratory function, anthropometry assessment, and diet intake evaluation of 13 COPD patients (COPD group, ten symptomatic elderly smokers (SYSM group, and 27 healthy volunteers (control group were compared. All were 70 years old or older.Results: The SYSM group had lower body weight, body mass index, percentage ideal body weight, body fat percentage, arm muscle circumference, tricep skin fold thickness, serum albumin, prealbumin, and transferrin than the control group and were similar to the COPD group (P < 0.05 each and nonsignificant each. Resting energy expenditure was no different among the groups. Intake of energy, vitamins (A, B1, B2, and C, calcium, iron, fiber, and sodium was also lower in the SYSM group than in the control group (P < 0.05 all and was similar to the COPD group.Conclusion: Elderly smokers who are symptomatic but who do not fulfill the COPD diagnostic criteria have nutritional deficits related to insufficient energy intake that are similar to those seen in COPD patients.Keywords: chronic obstructive pulmonary disease (COPD, nutritional status, body composition, resting energy expenditure (REE

  13. 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.

  14. 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...

  15. Prevalence of Ocular, Respiratory and Cutaneous Symptoms in Indoor Swimming Pool Workers and Exposure to Disinfection By-Products (DBPs)

    OpenAIRE

    Guglielmina Fantuzzi; Elena Righi; Guerrino Predieri; Pierluigi Giacobazzi; Katia Mastroianni; Gabriella Aggazzotti

    2010-01-01

    The objective of this cross-sectional study was to investigate the prevalence of self-reported respiratory, ocular and cutaneous symptoms in subjects working at indoor swimming pools and to assess the relationship between frequency of declared symptoms and occupational exposure to disinfection by-products (DBPs). Twenty indoor swimming pools in the Emilia Romagna region of Italy were included in the study. Information about the health status of 133 employees was collected using a self-adminis...

  16. Infant Infections and Respiratory Symptoms in Relation to in Utero Arsenic Exposure in a U.S. Cohort

    OpenAIRE

    Farzan, Shohreh F.; Li, Zhigang; Korrick, Susan A.; Spiegelman, Donna; Enelow, Richard; Nadeau, Kari; Baker, Emily; Margaret R Karagas

    2015-01-01

    Background: Arsenic has been linked to disrupted immune function and greater infection susceptibility in highly exposed populations. Well arsenic levels above the U.S. EPA limit occur in our U.S. study area and are of particular concern for pregnant women and infants. Objectives: We investigated whether in utero arsenic exposure affects the risk of infections and respiratory symptoms over the first year of life. Methods: We prospectively obtained information on infant infections and symptoms,...

  17. Respiratory symptoms and peripheral airways disease in a cross-sectional study on a random population sample

    OpenAIRE

    Olofson, Jan Yngve; Houltz, Birgitta; Nilsson Tengelin, Maria; Bake, Björn

    2012-01-01

    Objectives Respiratory symptoms are associated with spirometry results but more strongly with smoking history, suggesting that alterations in the lung other than those revealed by spirometry contribute to cause symptoms. Smoking may cause obstruction of peripheral airways that is poorly detected by spirometry. The slope of phase III of the single-breath nitrogen (N2) test detects smoking-induced alterations in smokers before spirometry is impaired. The aim of the present investigation was to ...

  18. 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.

  19. Parental Ease in Asking Others Not to Smoke and Respiratory Symptoms and Illness among Children

    Directory of Open Access Journals (Sweden)

    John Spangler

    2014-02-01

    Full Text Available Objective: Childhood exposure to secondhand tobacco smoke (SHS increases a child’s burden of respiratory conditions, but parental smoking bans may reduce such morbidity. This study evaluated household smoking bans and their relationship to respiratory illness in an outpatient otolaryngology clinic. Methods: The study was performed at the Heim Pal National Children’s Hospital, Ear, Nose and Throat (ENT Department (Budapest, Hungary from July to November, 2010. A consecutive series of children’s caregivers were approached to participate in a survey measuring household smoking bans, upper and lower respiratory tract symptoms and illnesses, and socioeconomic factors. Bivariate and multivariate logistic regression analyses were performed. Results: Of the 215 caregivers recruited for the study, 208 agreed to participate (response rate of 96.7%. More than half of the children were male (54%, and 39% lived in a household with at least one member who smoked. Smoking was frequently banned inside the car (91.3% and home (85.1%. Respondents felt it easiest to ask friends (97.1% and family members not living in the household (98.1% to refrain from smoking inside the home. Respondents also found it easier to ask a stranger (81.7% or a family member (61.1% not to smoke around the child. Logistic regression showed that respondents for children with a history of pneumonia found it less difficult to ask visitors in the home not to smoke compared to children without pneumonia (OR = 0.23, 95% CI = 0.06–0.98. Conversely, respondents for children who had had adenoidectomy found it over three times more difficult to ask strangers not to smoke near the child compared to those of children without adenoidectomy (OR = 3.20, 95% CI = 1.43–6.38. Conclusions: In a population of children visiting an outpatient ENT clinic in Budapest, Hungary, we found a high degree of exposure to SHS. The ease with which caregivers felt towards asking others not to smoke predicted

  20. Solving the conundrum of Job: a probable biblical description of chronic renal failure with neurological symptoms.

    Science.gov (United States)

    Resende, Luiz Antonio de Lima; Kirchner, Daniel Rocco; Ruiz e Resende, Lucilene Silva

    2009-06-01

    The disease described in the Bible's Book of Job is controversial and had been of interest of theologists, psychiatrists, and dermatologists for many years. We describe several signs and symptoms compatible with chronic renal failure with neurological alterations.

  1. Symptoms of respiratory tract infection and associated care-seeking in subjects with and without obstructive lung disease; The Tromsø Study: Tromsø 6

    Directory of Open Access Journals (Sweden)

    Melbye Hasse

    2012-09-01

    Full Text Available Abstract Background Respiratory tract infections (RTIs may be more severe in those with asthma or COPD and these patients are more frequently in need of health care. The aim of the study was to describe the frequency of RTI symptoms in a general adult population and how care-seeking is associated with the presence of obstructive lung disease. Methods Cross-sectional data including spirometry and self-reported chronic diseases were collected among middle-aged and elderly subjects in the Tromsø population survey (Tromsø 6. Self- reported RTI symptoms, consultations and antibiotic use were the main outcome variables. Possible predictors of RTI symptoms were evaluated by multivariable logistic regression. Results Of the 6414 subjects included, 798 (12.4% reported RTI symptoms in the previous week. RTI symptoms were reported less frequently by subjects aged 75 years or above, than by those younger than 55 years (OR 0.5. Winter season (OR 1.28, current smoking (OR 1.60, low self-rated health (OR 1.26 and moderate to severe bronchial obstruction (OR 1.51, were also statistically significant independent predictors of RTI symptoms, but these variables did not predict RTI symptoms that had started within the previous seven days. Among subjects with RTI symptoms, 5.1% also reported a consultation with a doctor. In those with bronchial obstruction by spirometry, who did not report asthma or COPD, this frequency was 2.4%. Antibiotic treatment was reported by 7.4% of the participants, among whom one third had consulted a doctor. Antibiotics were taken more frequently when asthma or COPD was reported (13.7%, but not in subjects with bronchial obstruction who did not report these diseases (7.2%. Conclusions RTI symptoms seldom led to consultation with a doctor and not even in subjects with obstructive lung disease. This was in particular the case in subjects who did not know about their obstructive lung disease. Strategies for early diagnosis of COPD and

  2. Symptoms and impact of symptoms on function and health in patients with chronic obstructive pulmonary disease and chronic heart failure in primary health care

    Directory of Open Access Journals (Sweden)

    Theander K

    2014-07-01

    Full Text Available Kersti Theander,1,2 Mikael Hasselgren,2,3 Kristina Luhr,4 Jeanette Eckerblad,5 Mitra Unosson,5 Ingela Karlsson1 1Department of Nursing, Faculty of Health Science and Technology, Karlstad University, Karlstad, Sweden; 2Primary Care Research Unit, County Council of Värmland, Karlstad, Sweden; 3Department of Medicine, Örebro University, Örebro, Sweden; 4Family Medicine Research Centre, Örebro County Council, Örebro, Sweden; 5Department of Social and Welfare Studies, Faculty of Health Sciences, Linköping University, Linköping, Sweden Background: Patients with chronic obstructive pulmonary disease (COPD and chronic heart failure (CHF seem to have several symptoms in common that impact health. However, methodological differences make this difficult to compare. Aim: Comparisons of symptoms, impact of symptoms on function and health between patients with COPD and CHF in primary health care (PHC. Method: The study is cross sectional, including patients with COPD (n=437 and CHF (n=388, registered in the patient administrative systems of PHC. The patients received specific questionnaires – the Memorial Symptom Assessment Scale, the Medical Research Council dyspnea scale, and the Fatigue Impact Scale – by mail and additional questions about psychological and physical health. Results: The mean age was 70±10 years and 78±10 years for patients with COPD and CHF respectively (P=0.001. Patients with COPD (n=273 experienced more symptoms (11±7.5 than the CHF patients (n=211 (10±7.6. The most prevalent symptoms for patients with COPD were dyspnea, cough, and lack of energy. For patients with CHF, the most prevalent symptoms were dyspnea, lack of energy, and difficulty sleeping. Experience of dyspnea, cough, dry mouth, feeling irritable, worrying, and problems with sexual interest or activity were more common in patients with COPD while the experience of swelling of arms or legs was more common among patients with CHF. When controlling for background

  3. 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

  4. 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

  5. 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.

  6. Estudo comparativo de sintomas respiratórios e função pulmonar em pacientes com doença pulmonar obstrutiva crônica relacionada à exposição à fumaça de lenha e de tabaco Comparative study of respiratory symptoms and lung function alterations in patients with chronic obstructive pulmonary disease related to the exposure to wood and tobacco smoke

    Directory of Open Access Journals (Sweden)

    Maria Auxiliadora Carmo Moreira

    2008-09-01

    Full Text Available OBJETIVO: Descrever e analisar sintomas respiratórios e alterações espirométricas em pacientes portadores de doença pulmonar obstrutiva crônica (DPOC, com história de exposição à fumaça de lenha e de tabaco. MÉTODOS: Foram avaliados retrospectivamente dados de 170 pacientes distribuídos em 3 grupos: 34 pacientes expostos somente à fumaça de lenha, 59 pacientes, somente à de tabaco e 77 pacientes expostos a ambas. RESULTADOS: Os grupos não diferiram quanto a idade (p = 0,225 e grau de exposição, considerando cada tipo de exposição isoladamente ou em associação (p = 0,164 e p = 0,220, respectivamente. No grupo exposto à fumaça de lenha predominou o sexo feminino.Não houve diferença entre os grupos quanto à freqüência dos sintomas respiratórios (p > 0,05, e houve predominância de grau moderado de dispnéia nos três grupos (p = 0,141. O grupo exposto à fumaça de lenha apresentou melhores percentuais da relação volume expiratório forçado no primeiro segundo/capacidade vital forçada e de volume expiratório forçado no primeiro segundo (p OBJECTIVE: To describe and analyze clinical symptoms and spirometric alterations of patients with chronic obstructive pulmonary disease (COPD and history of exposure to wood and tobacco smoke. METHODS: We retrospectively evaluated data related to 170 patients distributed into 3 groups: 34 exposed only to wood smoke, 59 patients exposed only to tobacco smoke and 77 patients exposed to both. RESULTS: The groups did not differ significantly in terms of age (p = 0.225 or degree of exposure, considering each type of exposure in isolation or in combination (p = 0.164 and p = 0.220, respectively. Females predominated in the group exposed to wood smoke. There were no differences among the groups regarding respiratory symptoms (p > 0.05, and moderate dyspnea predominated in the three groups (p = 0.141. The group exposed to wood smoke presented higher percentages of forced expiratory

  7. Chronic pain and the development of a symptom checklist: a pilot study

    DEFF Research Database (Denmark)

    Kendall, S; Holm, Ninna Rose; Højsted, J;

    2013-01-01

    There is currently no instrument to systematically assess the range of symptoms/problems and their bothersomeness in patients with chronic non-cancer pain (CNPN). Systematic assessment and prioritizing may target treatments and improve outcomes.......There is currently no instrument to systematically assess the range of symptoms/problems and their bothersomeness in patients with chronic non-cancer pain (CNPN). Systematic assessment and prioritizing may target treatments and improve outcomes....

  8. Development of a symptom assessment instrument for chronic hemodialysis patients: the Dialysis Symptom Index.

    Science.gov (United States)

    Weisbord, Steven D; Fried, Linda F; Arnold, Robert M; Rotondi, Armando J; Fine, Michael J; Levenson, David J; Switzer, Galen E

    2004-03-01

    Little is known about the prevalence, severity, or impact of symptoms in hemodialysis patients because of the lack of a validated symptom assessment instrument. We systematically developed an index to assess physical and emotional symptom burden in this patient population. We employed four steps in the generation of this index: a review of dialysis quality-of-life instruments, three focus groups, experts' content validity assessment, and test-retest reliability measurement. Seventy-five symptoms were identified. Of these, 46 appeared in > or = 4 of the instruments/focus groups and were considered for inclusion. Twelve were grouped into other symptom constructs and experts judged four of the remaining items not to be pertinent, leaving 30 items in the new index. Overall kappa statistic was 0.48+/-0.22. These steps allowed the systematic development of a 30-item symptom assessment index for hemodialysis patients. Additional reliability and validity testing is needed prior to its widespread use.

  9. 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.

  10. 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

  11. Patient- versus physician-reporting of symptoms and health status in chronic myeloid leukemia

    NARCIS (Netherlands)

    F. Efficace; G. Rosti; N. Aaronson; F. Cottone; E. Angelucci; S. Molica; M. Vignetti; F. Mandelli; M. Baccarani

    2013-01-01

    The main objective of this study was to compare the reporting of health status and symptom severity, for a set of core symptoms related to imatinib therapy, between chronic myeloid leukemia patients and their treating physicians. Patients were asked to complete a questionnaire including questions on

  12. Infants with recurrent lower respiratory tract symptoms – who benefits of extensive investigations?

    Directory of Open Access Journals (Sweden)

    Anne Kotaniemi-Syrjänen

    2008-04-01

    Full Text Available There is limited information on lung function and exhaled nitric oxide fraction (FeNO in infants with recurrent lower respiratory tract symptoms. In 2000–2003, 201 recurrently symptomatic infants were referred to a tertiary center for further investigation. As part of the clinical investigation, whole-body plethysmography, tidal FeNO measurements, and skin prick tests were performed. In addition, 77 (38% of the children underwent bronchoscopy. Increased work of breathing in clinical examination (in 22%, and abnormal chest radiograph (in 30%, were associated with decreased airway conductance (sGaw z-score –1.65 (p<0.001 and p = 0.048, respectively and hyperinflation of the lungs (FRC z-score 1.65(p = 0.004 and p = 0.038, respectively. Exposure to environmental tobacco smoke (ETS was associated with FeNO 40 ppb (p = 0.009. Increased work of breathing, sGaw z-score –1.65, and FRC z-score 1.65, were associated with low FeNO (p = 0.002, p = 0.005, p = 0.026, respectively. A definitive diagnosis was made in 184 (92% children; asthma was diagnosed in 149 (74%, infection in 23 (11%, and a structural abnormality in 12 (6%. Abnormal findings in clinical examination predicted the diagnosis of asthma or a structural abnormality in 96% of cases, whereas in children with underlying respiratory infection or no definitive diagnosis, clinical examination was normal in 92% (p<0.001. In conclusion, clinical findings of bronchial obstruction predict well lung function and the diagnosis of asthma in recurrently symptomatic infants. FeNO is affected by ETS exposure, clinical state of the child, and the used methods, and the information obtained should be interpreted with care.

  13. Respiratory symptoms in rheumatoid arthritis: relation to pulmonary abnormalities detected by high-resolution CT and pulmonary functional testing.

    Science.gov (United States)

    Youssef, Amir A; Machaly, Shereen A; El-Dosoky, Mohammed E; El-Maghraby, Nermeen M

    2012-07-01

    Pulmonary disease is the most frequent and among the most severe extra-articular manifestation of rheumatoid arthritis (RA). However, this issue has not been sufficiently studied in Egyptian patients. The objectives of the present study are to investigate the prevalence and types of pulmonary involvement using high-resolution computed tomography scan (HRCT) and pulmonary function tests (PFT) and evaluate the association between respiratory symptoms and RA-lung disease in a group of Egyptian RA patients. Thirty-six RA patients were recruited; 34 females (94.4%) and 2 males (5.6%) with median age of 48.5 years, and none of them was smoker. Detailed medical and drug histories were obtained. PFT, plain X-ray of the chest, and HRCT were performed to all subjects involved. Nearly 64% of RA patients demonstrated abnormalities in PFT and 47% in HRCT. Mixed restrictive and obstructive pattern was the commonest. Nearly two-thirds of our patients reported one or more pulmonary symptom whether dyspnea, cough, wheezing, or phlegm. Dyspnea was the most frequent symptom. Respiratory symptoms were statistically more common in patients with lung disease. The advanced age, high radiological score, and severity of rheumatoid disease were found to be predictive of lung involvement. Among respiratory symptoms, dyspnea and cough were associated with any pulmonary abnormalities. When specific pulmonary abnormalities were considered, only dyspnea was identified as predictor for restriction. For obstructive abnormality, both cough and wheezing provided valid prediction. We conclude that pulmonary involvement is a common manifestation in Egyptian RA patients, and the pattern of involvement is generally consistent with other studies that were performed worldwide. Specific respiratory symptoms could be used as practical, easy, and cost-effective method, especially in older and with more severe RA patients, to discriminate patients in need of subsequent PFT and HRCT imaging.

  14. Chronic thought suppression and posttraumatic symptoms: data from the Madrid March 11, 2004 terrorist attack.

    Science.gov (United States)

    Vázquez, Carmelo; Hervás, Gonzalo; Pérez-Sales, Pau

    2008-12-01

    Although a considerable number of people either witnessed directly or in the mass media the traumatic scenes of the terrorist attack that took place on March 11th, 2004 in Madrid, only a fraction of Madrid citizens developed posttraumatic symptoms. In this study, posttraumatic stress-related symptoms, degree of exposure, coping strategies related to the attack, and chronic attempts to avoid intrusive thoughts (i.e., thought suppression) were assessed in a general population Madrid sample (N=503) 2-3 weeks after the attacks. Our results showed that participants with higher scores in chronic thought suppression exhibited higher levels of PTSD symptoms. Higher scores in chronic thought suppression also correlated positively with the use of avoidant coping strategies after the attacks. We discuss the possible common roots of avoidance of intrusive thoughts and avoidant coping strategies and the implications of this relationship for the emergence of stress-related symptoms as well as for public health policies. PMID:18329844

  15. Altered amygdala connectivity in individuals with chronic traumatic brain injury and comorbid depressive symptoms

    Directory of Open Access Journals (Sweden)

    Kihwan eHan

    2015-11-01

    Full Text Available Depression is one of the most common psychiatric conditions in individuals with chronic Traumatic Brain Injury (TBI. Though depression has detrimental effects in TBI and network dysfunction is a 'hallmark' of TBI and depression, there have not been any prior investigations of connectivity-based neuroimaging biomarkers for comorbid depression in TBI. We utilized resting-state functional magnetic resonance imaging to identify altered amygdala connectivity in individuals with chronic TBI (eight years post-injury on average exhibiting comorbid depressive symptoms (N=31, relative to chronic TBI individuals having minimal depressive symptoms (N=23. Connectivity analysis of these participant sub-groups revealed that the TBI-plus-depressive symptoms group showed relative increases in amygdala connectivity primarily in the regions that are part of the salience, somatomotor, dorsal attention and visual networks (pvoxel<0.01, pcluster<0.025. Relative increases in amygdala connectivity in the TBI-plus-depressive symptoms group were also observed within areas of the limbic-cortical mood-regulating circuit (the left dorsomedial and right dorsolateral prefrontal cortices and thalamus and the brainstem. Further analysis revealed that spatially-dissociable patterns of correlation between amygdala connectivity and symptom severity according to subtypes (Cognitive and Affective of depressive symptoms (pvoxel<0.01, pcluster<0.025. Taken together, these results suggest that amygdala connectivity may be a potentially effective neuroimaging biomarker for comorbid depressive symptoms in chronic TBI.

  16. 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

  17. Respiratory Symptoms and Lung Function in Never-Smoking Male Workers Exposed To Hardwood Dust

    Directory of Open Access Journals (Sweden)

    Dragana Bislimovska

    2015-07-01

    CONCLUSION: Our data suggest that workplace exposure to hardwood dust may lead to adverse respiratory effects indicating the need of adequate preventive measures in order to protect the respiratory health of exposed workers.

  18. Swimming pool attendance and respiratory symptoms and allergies among Dutch children

    NARCIS (Netherlands)

    Jacobs, J.H.; Fuertes, E.; Krop, E.J.M.; Spithoven, J.; Tromp, P.; Heederik, D.J.J.

    2012-01-01

    Objectives: To describe associations among swimming, respiratory health, allergen sensitisation and Clara cell protein 16 (CC16) levels in Dutch schoolchildren. Trichloramine levels in swimming pool air were determined to assess potential exposure levels. Methods: Respiratory health and pool attenda

  19. Swimming pool attendance and respiratory symptoms and allergies among Dutch children

    NARCIS (Netherlands)

    Jacobs, J.H.; Fuertes, E.; Krop, E.J.M.; Spithoven, J.; Tromp, P.; Heederik, D.J.J.

    2012-01-01

    OBJECTIVES To describe associations among swimming, respiratory health, allergen sensitisation and Clara cell protein 16 (CC16) levels in Dutch schoolchildren. Trichloramine levels in swimming pool air were determined to assess potential exposure levels. METHODS Respiratory health and pool attendanc

  20. Cross sectional analysis of respiratory symptoms in an injection drug user cohort: the impact of obstructive lung disease and HIV

    Directory of Open Access Journals (Sweden)

    Mehta Shruti H

    2010-05-01

    Full Text Available Abstract Background Injection drug use is associated with an increased risk of human immunodeficiency virus (HIV infection and with obstructive lung diseases (OLD. Understanding how HIV and OLD may impact respiratory symptoms among injection drug users (IDUs is important to adequately care for this high-risk population. We characterized the independent and joint effects of HIV and OLD on respiratory symptoms of a cohort of inner-city IDUs. Methods Demographics, risk behavior and spirometric measurements were collected from a cross-sectional analysis of the Acquired Immunodeficiency Syndrome Link to the IntraVenous Experience study, an observational cohort of IDUs followed in Baltimore, MD since 1988. Participants completed a modified American Thoracic Society respiratory questionnaire and the Medical Research Council (MRC dyspnea score to assess respiratory symptoms of cough, phlegm, wheezing and dyspnea. Results Of 974 participants, 835 (86% were current smokers and 288 (29.6% were HIV-infected. The prevalence of OLD (FEV1/FVC ≤ 0.70 was 15.5%, and did not differ by HIV status. OLD, but not HIV, was associated with increased frequency of reported respiratory symptoms. There was a combined effect of OLD and HIV on worsening of MRC scores. OLD and HIV were independently associated with an increased odds of reporting an MRC ≥ 2 (OR 1.83 [95%CI 1.23-2.73] and 1.50 [95%CI 1.08-2.09], respectively. COPD, but not HIV, was independently associated with reporting an MRC ≥ 3 (OR 2.25 [95%CI 1.43-3.54] and 1.29 [95%CI 0.87-1.91], respectively. Conclusions While HIV does not worsen cough, phlegm or wheezing, HIV significantly increases moderate but not severe dyspnea in individuals of similar OLD status. Incorporating the MRC score into routine evaluation of IDUs at risk for OLD and HIV provides better assessment than cough, phlegm and wheezing alone.

  1. Respiratory sinus arrhythmia reactivity to a sad film predicts depression symptom improvement and symptomatic trajectory.

    Science.gov (United States)

    Panaite, Vanessa; Hindash, Alexandra Cowden; Bylsma, Lauren M; Small, Brent J; Salomon, Kristen; Rottenberg, Jonathan

    2016-01-01

    Respiratory sinus arrhythmia (RSA) reactivity, an index of cardiac vagal tone, has been linked to self-regulation and the severity and course of depression (Rottenberg, 2007). Although initial data supports the proposition that RSA withdrawal during a sad film is a specific predictor of depression course (Fraguas, 2007; Rottenberg, 2005), the robustness and specificity of this finding are unclear. To provide a stronger test, RSA reactivity to three emotion films (happy, sad, fear) and to a more robust stressor, a speech task, were examined in currently depressed individuals (n=37), who were assessed for their degree of symptomatic improvement over 30weeks. Robust RSA reactivity to the sad film uniquely predicted overall symptom improvement over 30weeks. RSA reactivity to both sad and stressful stimuli predicted the speed and maintenance of symptomatic improvement. The current analyses provide the most robust support to date that RSA withdrawal to sad stimuli (but not stressful) has specificity in predicting the overall symptomatic improvement. In contrast, RSA reactivity to negative stimuli (both sad and stressful) predicted the trajectory of depression course. Patients' engagement with sad stimuli may be an important sign to attend to in therapeutic settings. PMID:26681648

  2. Simptomi in znaki s področja spodnjih dihal v ambulanti družinskega zdravnika: Lower respiratory tract symptoms in family practice:

    OpenAIRE

    Kopčavar Guček, Nena; Mazej Poredoš, Barbara

    2012-01-01

    Cough, dyspnea.chest pain, wheezing, hemoptysis, hemoptoe, abnormal breathing patterns and sputum are the main symptoms of lower respiratory tract disease, which can easily be recognized via a thorough examination of medical history in a family practice. The specificity of the symptoms varies greatly. While cough can indicate the involvement of several organs, wheezing is highly indicative of lower respiratory tract disease. This article discusses some of the lung symptoms and signs, their ch...

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

    OpenAIRE

    Bruno-Pierre Dubé; Piergiuseppe Agostoni; Pierantonio Laveneziana

    2016-01-01

    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 o...

  4. [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

  5. Depressive symptoms and perceived chronic stress predict test anxiety in nursing students

    Directory of Open Access Journals (Sweden)

    Christoph Augner

    2015-09-01

    Full Text Available Aim: The aim of this study is to identify predictors of test anxiety in nursing students. Design: Cross sectional pilot study. Methods: A questionnaire was administered to 112 students of an Austrian nursing school (mean age = 21.42, SD = 5.21. Test anxiety (measured by the standardized PAF Test Anxiety Questionnaire, perceived chronic stress, depressive symptoms, pathological eating and further psychological and health parameters were measured. Results: We found highly significant correlations between test anxiety and working hours (0.25, depression score (0.52, emotional stability (-0.31, and perceived chronic stress (0.65 (p < 0.01, for all. Regression analysis revealed chronic stress and emotional instability as best predictors for test anxiety. Furthermore, path analysis revealed that past negative academic performance outcomes contribute to test anxiety via depressive symptoms and perceived chronic stress. Conclusion: Depressive symptoms and perceived chronic stress are strongly related to test anxiety. Therefore therapy and training methods that address depressive symptoms and perceived chronic stress, and thereby aim to modify appraisal of potential stressful situations, may be successful in addressing test anxiety.

  6. Effects of Short-Term Exposure to Particulate Air Pollutants on the Inflammatory Response and Respiratory Symptoms: A Panel Study in Schoolchildren from Rural Areas of Japan

    Science.gov (United States)

    Watanabe, Masanari; Noma, Hisashi; Kurai, Jun; Sano, Hiroyuki; Hantan, Degejirihu; Ueki, Masaru; Kitano, Hiroya; Shimizu, Eiji

    2016-01-01

    The relationship between particulate air pollutants and respiratory symptoms in children has not been consistent among studies, potentially owing to differences in the inflammatory response to different particulate air pollutants. This study aimed to investigate the effect of particulate air pollutants on respiratory symptoms and the inflammatory response in schoolchildren. Three hundred-and-sixty children were included in the study. The children recorded daily respiratory symptom scores for October 2015. In addition, the daily amount of interleukin (IL)-6, IL-8, and tumor necrosis factor (TNF)-α production was assessed in THP1 cells stimulated with suspended particulate matter (SPM), which was collected every day during the study period. Generalized estimating equation logistic regression analyses were used to estimate the associations among respiratory symptoms and the daily levels of SPM, IL-6, IL-8, and TNF-α. Daily SPM levels were not associated with respiratory symptoms or the daily IL-6, IL-8, and TNF-α levels. Conversely, there was a significant association between respiratory symptoms and the daily IL-6, IL-8, and TNF-α levels. These results suggested that the effects of particulate air pollutants on respiratory symptoms in schoolchildren might depend more on the pro-inflammatory response to them than on their mass concentration. PMID:27706066

  7. Occupational exposure to second hand smoke and respiratory and sensory symptoms: A cross-sectional survey of hospital workers in Egypt

    Directory of Open Access Journals (Sweden)

    Ghada Radwan

    2014-02-01

    Full Text Available Objective: Exposure to Second Hand Smoke (SHS has been associated with an increased risk of respiratory symptoms, upper and lower respiratory tract diseases and an increased risk of asthma and chronic obstructive pulmonary disease. The majority of cases of mortality and morbidity is attributable to exposure of adults to SHS and is related to cardiovascular diseases and lung cancer. In Egypt, comprehensive smoke-free laws exist, however, in many workplaces they are poorly enforced consequently exposing workers to the detrimental health hazards of SHS. We aimed at determination of workplace exposure to Second Hand Smoke (SHS and its association with respiratory and sensory irritation symptoms in hospital workers in Port-said governorate in Egypt. Material and methods: A cross-sectional face to face survey was conducted by the use of a standardised questionnaire among 415 adult hospital workers; representing 50% of all employees (81% response rate; recruited from 4 randomly selected general hospitals in Port-said governorate in Egypt. Results: All hospitals employees reported exposure to SHS - on average 1.5 (SD = 2.5 hours of exposure per day. After controlling for potential confounders, exposure to SHS at work was significantly associated with an increased risk of wheezes (OR = 1.14, p < 0.01, shortness of breath (OR = 1.17, p < 0.01, phlegm (OR = 1.23, p < 0.01, running and irritated nose (OR = 1.14, p < 0.01 as well as a sore, scratchy throat (OR = 1.23. Conclusions: These findings point out that workplace exposure to SHS is evident in hospitals in Port-said governorate and that workers are adversely affected by exposure to it at work. This underlines the importance of rigorous enforcement of smoke-free policies to protect the workers' health in Egypt.

  8. Urban air pollution and emergency room admissions for respiratory symptoms: a case-crossover study in Palermo, Italy

    Directory of Open Access Journals (Sweden)

    Calamusa Giuseppe

    2011-04-01

    Full Text Available Abstract Background Air pollution from vehicular traffic has been associated with respiratory diseases. In Palermo, the largest metropolitan area in Sicily, urban air pollution is mainly addressed to traffic-related pollution because of lack of industrial settlements, and the presence of a temperate climate that contribute to the limited use of domestic heating plants. This study aimed to investigate the association between traffic-related air pollution and emergency room admissions for acute respiratory symptoms. Methods From January 2004 through December 2007, air pollutant concentrations and emergency room visits were collected for a case-crossover study conducted in Palermo, Sicily. Risk estimates of short-term exposures to particulate matter and gaseous ambient pollutants including carbon monoxide, nitrogen dioxide, and sulfur dioxide were calculated by using a conditional logistic regression analysis. Results Emergency departments provided data on 48,519 visits for respiratory symptoms. Adjusted case-crossover analyses revealed stronger effects in the warm season for the most part of the pollutants considered, with a positive association for PM10 (odds ratio = 1.039, 95% confidence interval: 1.020 - 1.059, SO2 (OR = 1.068, 95% CI: 1.014 - 1.126, nitrogen dioxide (NO2: OR = 1.043, 95% CI: 1.021 - 1.065, and CO (OR = 1.128, 95% CI: 1.074 - 1.184, especially among females (according to an increase of 10 μg/m3 in PM10, NO2, SO2, and 1 mg/m3 in CO exposure. A positive association was observed either in warm or in cold season only for PM10. Conclusions Our findings suggest that, in our setting, exposure to ambient levels of air pollution is an important determinant of emergency room (ER visits for acute respiratory symptoms, particularly during the warm season. ER admittance may be considered a good proxy to evaluate the adverse effects of air pollution on respiratory health.

  9. 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.

  10. Genetic variation of human respiratory syncytial virus among children with fever and respiratory symptoms in Shanghai, China, from 2009 to 2012.

    Science.gov (United States)

    Liu, Jia; Mu, Yonglin; Dong, Wei; Yao, Fujia; Wang, Lili; Yan, Huajie; Lan, Ke; Zhang, Chiyu

    2014-10-01

    Human respiratory syncytial virus (HRSV) of genus Pneumovirus is one of the most common pathogens causing severe acute lower respiratory tract infection in infants and children. No information on the genotype distribution of HRSV is available in East China (e.g. Shanghai). From August 2009 to December 2012, 2407 nasopharyngeal swabs were collected from outpatient children with fever and respiratory symptoms in Shanghai. HRSV infection was determined using a multiplex RT-PCR assay. The second hypervariable region (HVR2) of G protein gene of HRSV was amplified and sequenced from HRSV positive samples. Genotypes were characterized by phylogenetic analyses. Of 2407 nasopharyngeal samples, 184 (7.6%) were tested as HRSV positive. From 160 positive subjects with sufficient nasopharyngeal samples, 69 HVR2 sequences were obtained by RT-PCR and sequencing. Three HRSV epidemic seasons were observed from August 2009 to December 2012, and an extreme outbreak of HRSV occurred in the 2009-2010 epidemic season. A genotype shift of predominant HRSV strains from B group in the 2009-2010 epidemic season to group A in the subsequent epidemic seasons was observed. Ten HRSV genotypes, including four group A genotypes NA1, NA3, NA4, and ON1, and six group B genotypes BA9, BA10, SAB4, CB1, BAc, and BA?, were detected in Shanghai. Seven genotypes (NA1, BA9-10, SAB4, CB1, BAc and BA?) were found in the 2009-2010 epidemic season. The co-circulation of multiple genotypes was associated with the extreme outbreak of HRSV among children with fever and respiratory symptoms in the 2009-2010 epidemic season.

  11. 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.

  12. 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

  13. The Diagnostic Value of Serum C-Reactive Protein for Identifying Pneumonia in Hospitalized Patients with Acute Respiratory Symptoms

    OpenAIRE

    Ruiz-González, Agustín; Utrillo, Laia; Bielsa, Silvia; Falguera, Miquel; PORCEL, José M.

    2016-01-01

    Background. The clinical diagnosis of pneumonia is sometimes difficult since chest radiographs are often indeterminate. In this study, we aimed to assess whether serum C-reactive protein (CRP) could assist in identifying patients with pneumonia. Methods. For one winter, all consecutive patients with acute respiratory symptoms admitted to the emergency ward of a single center were prospectively enrolled. In addition to chest radiographs, basic laboratory tests, and microbiology, serum levels o...

  14. 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)....

  15. 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

  16. 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

  17. Functional Incapacity and Physical and Psychological Symptoms: How They Interconnect in Chronic Fatigue Syndrome

    OpenAIRE

    Priebe, Stefan; Fakhoury, Walid K. H.; Henningsen, Peter

    2008-01-01

    Background: It has been argued that perceived functional incapacity might be a primary characteristic of chronic fatigue syndrome ( CFS) and could be explained by physical symptoms. If so, it could be expected to be closely associated with physical, but not psychological symptoms. The study tests this hypothesis. Sampling and Methods: The sample consisted of 73 patients, with a diagnosis of CFS according to the Oxford criteria, randomly selected from clinics in the Departments of Immunology a...

  18. Bupropion Reduces Some of the Symptoms of Marihuana Withdrawal in Chronic Marihuana Users: A Pilot Study

    OpenAIRE

    Penetar, David M.; Looby, Alison R.; Ryan, Elizabeth T.; Maywalt, Melissa A.; Lukas, Scott E

    2012-01-01

    Bupropion’s (Zyban® SR) effectiveness to treat symptoms experienced in marihuana withdrawal was tested in a double-blind, placebo-controlled study with chronic, heavy marihuana users. Participants maintained their usual marihuana intake until Quit Day after which they were required to cease intake of THC products for 14 days. A Withdrawal Discomfort Score revealed that for 7 days immediately following cessation, placebo-treated subjects reported more symptoms than bupropion-treated subjects. ...

  19. Association between endothelial dysfunction and depression-like symptoms in chronic mild stress model of depression

    DEFF Research Database (Denmark)

    Bouzinova, Elena; Bødtkjer, Donna Marie Briggs; Kudryavtseva, Olga;

    2014-01-01

    OBJECTIVE: Cardiovascular diseases have high comorbidity with major depression. Endothelial dysfunction may explain the adverse cardiovascular outcome in depression; therefore, we analyzed it in vitro. In the chronic mild stress model, some rats develop depression-like symptoms (including...... "anhedonia"), whereas others are stress resilient. METHODS: After 8 weeks of chronic mild stress, anhedonic rats reduced their sucrose intake by 55% (7%), whereas resilient rats did not. Acetylcholine-induced endothelium-dependent relaxation of norepinephrine-preconstricted mesenteric arteries was analyzed...

  20. 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 ...

  1. Increased respiratory symptoms in COPD patients living in the vicinity of livestock farms

    NARCIS (Netherlands)

    Borlée, Floor; Yzermans, C Joris; van Dijk, Christel E; Heederik, Dick; Smit, Lidwien A M

    2015-01-01

    Several studies have investigated the effect of livestock farm emissions on the respiratory health of local residents, but results are inconsistent. This study aims to explore associations between the presence of livestock farms and respiratory health in an area of high-density livestock farming in

  2. Dampness and mould in schools and respiratory symptoms in children: the HITEA study.

    NARCIS (Netherlands)

    Borràs-Santos, A.; Jacobs, J.H.; Täubel, M.; Haverinen-Shaughnessy, U.; Krop, E.J.M.; Huttunen, K.; Hirvonen, M.R.; Pekkanen, J.; Heederik, D.J.J.; Zock, J.P.; Hyvärinen, A.

    2013-01-01

    Background:The adverse respiratory health effects of dampness and mould in the home have been extensively reported, but few studies have evaluated the health effects of such exposures in schools. Objectives: To assess the associations between dampness and mould in school buildings and respiratory sy

  3. [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.

  4. 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.

  5. Nonmalignant Respiratory Effects of Chronic Arsenic Exposure from Drinking Water among Never-Smokers in Bangladesh

    Science.gov (United States)

    Parvez, Faruque; Chen, Yu; Brandt-Rauf, Paul W.; Bernard, Alfred; Dumont, Xavier; Slavkovich, Vesna; Argos, Maria; D’Armiento, Jeanine; Foronjy, Robert; Hasan, M. Rashidul; Eunus, HEM Mahbubul; Graziano, Joseph H.; Ahsan, Habibul

    2008-01-01

    Background Arsenic from drinking water has been associated with malignant and nonmalignant respiratory illnesses. The association with nonmalignant respiratory illnesses has not been well established because the assessments of respiratory symptoms may be influenced by recall bias or interviewer bias because participants had visible skin lesions. Objectives We examined the relationship of the serum level of Clara cell protein CC16—a novel biomarker for respiratory illnesses—with well As, total urinary As, and urinary As methylation indices. Methods We conducted a cross-sectional study in nonsmoking individuals (n = 241) selected from a large cohort with a wide range of As exposure (0.1–761 μg/L) from drinking water in Bangladesh. Total urinary As, urinary As metabolites, and serum CC16 were measured in urine and serum samples collected at baseline of the parent cohort study. Results We observed an inverse association between urinary As and serum CC16 among persons with skin lesions (β = −0.13, p = 0.01). We also observed a positive association between secondary methylation index in urinary As and CC16 levels (β = 0.12, p = 0.05) in the overall study population; the association was stronger among people without skin lesions (β = 0.18, p = 0.04), indicating that increased methylation capability may be protective against As-induced respiratory damage. In a subsample of study participants undergoing spirometric measures (n = 31), we observed inverse associations between urinary As and predictive FEV1 (forced expiratory volume measured in 1 sec) (r = −0.37; FEV1/forced vital capacity ratio and primary methylation index (r = −0.42, p = 0.01). Conclusions The findings suggest that serum CC16 may be a useful biomarker of epithelial lung damage in individuals with arsenical skin lesions. Also, we observed the deleterious respiratory effects of As exposure at concentrations lower than reported in earlier studies. PMID:18288317

  6. The Neural Correlates of Chronic Symptoms of Vertigo Proneness in Humans.

    Directory of Open Access Journals (Sweden)

    Ola Alsalman

    Full Text Available Vestibular signals are of significant importance for variable functions including gaze stabilization, spatial perception, navigation, cognition, and bodily self-consciousness. The vestibular network governs functions that might be impaired in patients affected with vestibular dysfunction. It is currently unclear how different brain regions/networks process vestibular information and integrate the information into a unified spatial percept related to somatosensory awareness and whether people with recurrent balance complaints have a neural signature as a trait affecting their development of chronic symptoms of vertigo. Pivotal evidence points to a vestibular-related brain network in humans that is widely distributed in nature. By using resting state source localized electroencephalography in non-vertiginous state, electrophysiological changes in activity and functional connectivity of 23 patients with balance complaints where chronic symptoms of vertigo and dizziness are among the most common reported complaints are analyzed and compared to healthy subjects. The analyses showed increased alpha2 activity within the posterior cingulate cortex and the precuneues/cuneus and reduced beta3 and gamma activity within the pregenual and subgenual anterior cingulate cortex for the subjects with balance complaints. These electrophysiological variations were correlated with reported chronic symptoms of vertigo intensity. A region of interest analysis found reduced functional connectivity for gamma activity within the vestibular cortex, precuneus, frontal eye field, intra-parietal sulcus, orbitofrontal cortex, and the dorsal anterior cingulate cortex. In addition, there was a positive correlation between chronic symptoms of vertigo intensity and increased alpha-gamma nesting in the left frontal eye field. When compared to healthy subjects, there is evidence of electrophysiological changes in the brain of patients with balance complaints even outside chronic

  7. The Neural Correlates of Chronic Symptoms of Vertigo Proneness in Humans.

    Science.gov (United States)

    Alsalman, Ola; Ost, Jan; Vanspauwen, Robby; Blaivie, Catherine; De Ridder, Dirk; Vanneste, Sven

    2016-01-01

    Vestibular signals are of significant importance for variable functions including gaze stabilization, spatial perception, navigation, cognition, and bodily self-consciousness. The vestibular network governs functions that might be impaired in patients affected with vestibular dysfunction. It is currently unclear how different brain regions/networks process vestibular information and integrate the information into a unified spatial percept related to somatosensory awareness and whether people with recurrent balance complaints have a neural signature as a trait affecting their development of chronic symptoms of vertigo. Pivotal evidence points to a vestibular-related brain network in humans that is widely distributed in nature. By using resting state source localized electroencephalography in non-vertiginous state, electrophysiological changes in activity and functional connectivity of 23 patients with balance complaints where chronic symptoms of vertigo and dizziness are among the most common reported complaints are analyzed and compared to healthy subjects. The analyses showed increased alpha2 activity within the posterior cingulate cortex and the precuneues/cuneus and reduced beta3 and gamma activity within the pregenual and subgenual anterior cingulate cortex for the subjects with balance complaints. These electrophysiological variations were correlated with reported chronic symptoms of vertigo intensity. A region of interest analysis found reduced functional connectivity for gamma activity within the vestibular cortex, precuneus, frontal eye field, intra-parietal sulcus, orbitofrontal cortex, and the dorsal anterior cingulate cortex. In addition, there was a positive correlation between chronic symptoms of vertigo intensity and increased alpha-gamma nesting in the left frontal eye field. When compared to healthy subjects, there is evidence of electrophysiological changes in the brain of patients with balance complaints even outside chronic symptoms of vertigo

  8. Lactobacillus fermentum (PCC® supplementation and gastrointestinal and respiratory-tract illness symptoms: a randomised control trial in athletes

    Directory of Open Access Journals (Sweden)

    Hopkins William G

    2011-04-01

    Full Text Available Abstract Background Probiotics purportedly reduce symptoms of gastrointestinal and upper respiratory-tract illness by modulating commensal microflora. Preventing and reducing symptoms of respiratory and gastrointestinal illness are the primary reason that dietary supplementation with probiotics are becoming increasingly popular with healthy active individuals. There is a paucity of data regarding the effectiveness of probiotics in this cohort. The aim of this study was to evaluate the effectiveness of a probiotic on faecal microbiology, self-reported illness symptoms and immunity in healthy well trained individuals. Methods Competitive cyclists (64 males and 35 females; age 35 ± 9 and 36 ± 9 y, VO2max 56 ± 6 and 52 ± 6 ml.kg-1.min-1, mean ± SD were randomised to either probiotic (minimum 1 × 109 Lactobacillus fermentum (PCC® per day or placebo treatment for 11 weeks in a double-blind, randomised, controlled trial. The outcome measures were faecal L. fermentum counts, self-reported symptoms of illness and serum cytokines. Results Lactobacillus numbers increased 7.7-fold (90% confidence limits 2.1- to 28-fold more in males on the probiotic, while there was an unclear 2.2-fold (0.2- to 18-fold increase in females taking the probiotic. The number and duration of mild gastrointestinal symptoms were ~2-fold greater in the probiotic group. However, there was a substantial 0.7 (0.2 to 1.2 of a scale step reduction in the severity of gastrointestinal illness at the mean training load in males, which became more pronounced as training load increased. The load (duration×severity of lower respiratory illness symptoms was less by a factor of 0.31 (99%CI; 0.07 to 0.96 in males taking the probiotic compared with placebo but increased by a factor of 2.2 (0.41 to 27 in females. Differences in use of cold and flu medication mirrored these symptoms. The observed effects on URTI had too much uncertainty for a decisive outcome. There were clear reductions in

  9. 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

  10. 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.

  11. The user with respiratory symptoms of tuberculosis in the primary care: assessment of actions according to national recommendations

    Directory of Open Access Journals (Sweden)

    Luize Barbosa Antunes

    2016-06-01

    Full Text Available Objective: to investigate the evaluation of the user with respiratory symptoms of tuberculosis in Primary Health Care services according to the norms of the National Program for Tuberculosis Control. Methods: cross-sectional study with application of a form to 99 people with pulmonary tuberculosis. Results: a total of 87.9% participants reported cough as the symptom that motivated the search for Primary Care; from these, 27.3% sought Primary Care units, 96.3% received care in this service, of which 46.2% reported that sputum smear was requested by professionals in the units. Conclusion: more than half of participants sought secondary or tertiary services due to the symptoms of tuberculosis, and also less than half of patients assisted in Primary Care had diagnostic tests requested by professionals of that service.

  12. MRI and clinical symptoms in chronic cervical cord injury

    Energy Technology Data Exchange (ETDEWEB)

    Soeda, Shuichi; Maruiwa, Hirofumi; Yokoi, Masahiro; Saitoh, Seiya (Tsukigase Rehabilitation Center, Shizuoka (Japan)); Yamauchi, Kenji

    1992-08-01

    To assess the ability of magnetic resonance (MR) imaging to determine the prognosis of spinal cord injury in the chronic stage and to detect the injured myelomere, 39 patients were examined with MR images obtained by T1-weighted spin echo method 5 months to 4 years and 8 months (mean, one year and 5 months) after they had sustained spinal cord injury. According to hypointensity area of the ventrodorsad diameter of the spinal cord, MR images were classified as non-hypointensity (I), discrete (II), central (III), large cavity (IV), and transverse (V). The most common type was III (25%), followed by IV (26%), II (18%), V (15%), and I (13%). In 21 patients with bone injury, 14 (67%) had type IV or V, in contrast to 2 (11%) of 18 patients without bone injury. Increased hypointensity on MR images was associated with severer injury of the spinal cord. When hypointensity accounted for less than 1/2 of the ventrodorsad diameter of the spinal cord, walking ability was recovered in more than 80% of the patients. When less than 1/3 of the ventrodorsad diameter of the spinal cord was seen as hypointensity, arm function was well preserved, and the anterior horn of gray matter was found less injured. In 60% of the patients, there was difference in the injured level of myelomere between MR images and the neurological examination; the injured level of myelomere tended to be more cephalad level in the neurological examination than MR appearance.(N.K.).

  13. MRI and clinical symptoms in chronic cervical cord injury

    International Nuclear Information System (INIS)

    To assess the ability of magnetic resonance (MR) imaging to determine the prognosis of spinal cord injury in the chronic stage and to detect the injured myelomere, 39 patients were examined with MR images obtained by T1-weighted spin echo method 5 months to 4 years and 8 months (mean, one year and 5 months) after they had sustained spinal cord injury. According to hypointensity area of the ventrodorsad diameter of the spinal cord, MR images were classified as non-hypointensity (I), discrete (II), central (III), large cavity (IV), and transverse (V). The most common type was III (25%), followed by IV (26%), II (18%), V (15%), and I (13%). In 21 patients with bone injury, 14 (67%) had type IV or V, in contrast to 2 (11%) of 18 patients without bone injury. Increased hypointensity on MR images was associated with severer injury of the spinal cord. When hypointensity accounted for less than 1/2 of the ventrodorsad diameter of the spinal cord, walking ability was recovered in more than 80% of the patients. When less than 1/3 of the ventrodorsad diameter of the spinal cord was seen as hypointensity, arm function was well preserved, and the anterior horn of gray matter was found less injured. In 60% of the patients, there was difference in the injured level of myelomere between MR images and the neurological examination; the injured level of myelomere tended to be more cephalad level in the neurological examination than MR appearance.(N.K.)

  14. Prevalence of chronic cough in relation to upper and lower airway symptoms; the Skövde population-based study

    Directory of Open Access Journals (Sweden)

    Mats eBende

    2012-07-01

    Full Text Available The aim of this study was to determine the prevalence of chronic cough in relation to upper airway symptoms, in a cross-sectional, population-based epidemiological study. Another aim was to relate coughing to other explanatory variables and risk factors. A random sample of 1900 inhabitants from the age of 20, stratified for age and gender, was recruited. Subjects were invited for clinical examinations that included questions about general odor intolerance, respiratory symptoms, and smoking habits, and a smell identification test. In total, 1387 volunteers (73% of the sample were investigated. The overall prevalence of self-reported chronic cough was 6.3% (95% confidence interval (CI: 5.0-7.6%. Female gender, age, height, BMI, and smoking were significantly related to cough. Furthermore, nasal blockage, nasal secretion, sneezing, asthma, odor and cold air sensitivity, and aspirin intolerance also related to cough with statistical significance, indicating a close connection between chronic cough and upper airway symptoms. In keeping with other studies, this study demonstrates that chronic cough is a widespread problem in society, and is about twice as common in women than in men.

  15. 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

  16. Trabalho rural, exposição a poeiras e sintomas respiratórios entre agricultores Farm work, dust exposure and respiratory symptoms among farmers

    Directory of Open Access Journals (Sweden)

    Neice Müller Xavier Faria

    2006-10-01

    associated with increases in respiratory diseases. The objective of this study was to evaluate the prevalence of respiratory symptoms among farmers and the associations of these with occupational risk factors. METHODS: This cross-sectional study was undertaken in 1996 with 1,379 farmers from Southern Brazil. Sociodemographic and farming-production parameters were collected, as were levels of exposure to organic and mineral dusts. Respiratory symptoms were assessed by a modified version of American Thoracic Society-Division of Lung Disease questionnaire. Multiple logistic regression analysis was used in analyses, controlling for confounding factors. RESULTS: The majority (52% of interviewees worked in activities with intense exposure to dust. Workers on farms with better economic indicators had a lower prevalence of respiratory symptoms. Poultry workers showed more symptoms of chronic respiratory disease (OR=1.60; 95% CI: 1.05-2.42. Farmers exposed to high concentrations of dust had more than 70% higher risk of asthma symptoms (OR=1.71; 95% CI: 1.10-2.67 and chronic respiratory disease symptoms (OR=1.77; 95% CI: 1.25-2.50. CONCLUSIONS: The rural workers studied herein were exposed to high levels of organic and mineral dusts. Those exposed to higher dust concentrations, such as poultry workers, showed an increased risk of work-related respiratory symptoms. The implementation of respiratory protection programs is recommended, emphasizing workers involved with poultry production.

  17. The impact of chronic physical illness, maternal depressive symptoms, family functioning, and self-esteem on symptoms of anxiety and depression in children.

    Science.gov (United States)

    Ferro, Mark A; Boyle, Michael H

    2015-01-01

    The present study extends earlier research identifying an increased risk of anxiety among children with chronic physical illness (CwCPI) by examining a more complete model that explains how physical illness leads to increased symptoms of anxiety and depression. We tested a stress-generation model linking chronic physical illness to symptoms of anxiety and depression in a population-based sample of children aged 10 to 15 years. We hypothesized that having a chronic physical illness would be associated with more symptoms of anxiety and depression, increased levels of maternal depressive symptoms, more family dysfunction, and lower self-esteem; and, that maternal depressive symptoms, family dysfunction, and child self-esteem would mediate the influence of chronic physical illness on symptoms of anxiety and depression. Data came from the National Longitudinal Survey of Children and Youth (N = 10,646). Mediating processes were analyzed using latent growth curve modeling. Childhood chronic physical illness was associated with increases in symptoms of anxiety and depression, β = 0.20, p anxiety and depression. CwCPI are at-risk for symptoms of anxiety and depression. Some of this elevated risk appears to work through family processes and child self-esteem. This study supports the use of family-centered care approaches among CwCPI to minimize burden on families and promote healthy psychological development for children.

  18. Exposure to air pollution and respiratory symptoms during the first 7 years of life in an Italian birth cohort

    OpenAIRE

    Ranzi, Andrea; Porta, Daniela; Badaloni, Chiara; Cesaroni, Giulia; Lauriola, Paolo; Davoli, Marina; Forastiere, Francesco

    2014-01-01

    Background Ambient air pollution has been consistently associated with exacerbation of respiratory diseases in schoolchildren, but the role of early exposure to traffic-related air pollution in the first occurrence of respiratory symptoms and asthma is not yet clear. Methods We assessed the association between indexes of exposure to traffic-related air pollution during different periods of life and respiratory outcomes in a birth cohort of 672 newborns (Rome, Italy). Direct interviews of the ...

  19. Chronic bladder ischemia and oxidative stress: new pharmacotherapeutic targets for lower urinary tract symptoms.

    Science.gov (United States)

    Nomiya, Masanori; Andersson, Karl-Erik; Yamaguchi, Osamu

    2015-01-01

    Chronic bladder ischemia is potentially a common cause of lower urinary tract symptoms in the elderly. Epidemiological studies have shown a close association between lower urinary tract symptoms and vascular risk factors for atherosclerosis, and investigations using transrectal color Doppler ultrasonography have shown a negative correlation between decreased lower urinary tract perfusion and International Prostate Symptom Score in elderly patients with lower urinary tract symptoms. Bladder blood flow is also known to decrease in men with bladder outlet obstruction as a result of benign prostatic hyperplasia. Studies in animal models suggest that chronic bladder ischemia and repeated ischemia/reperfusion during a micturition cycle might produce oxidative stress, leading to denervation of the bladder and the expression of tissue-damaging molecules in the bladder wall, which could be responsible for the development of bladder hyperactivity progressing to bladder underactivity. The effects of drugs with different mechanisms of action; for example, α1-adrenoceptor antagonists, phosphodiesterase type 5 inhibitors, free radical scavengers and β3-adrenoceptor agonist, have been studied in animal models of chronic bladder ischemia. The drugs, representing different treatment principles for increasing blood flow and decreasing oxidative stress, showed protective effects not only on urodynamic parameters, but also on negative effects on muscle contractility and on detrimental structural bladder wall changes. Improvement of lower urinary tract perfusion and control of oxidative stress can be considered new therapeutic strategies for treatment of bladder dysfunction induced by chronic ischemia. PMID:25339506

  20. The relations among body consciousness, somatic symptom report, and information processing speed in chronic fatigue syndrome.

    NARCIS (Netherlands)

    Werf, S.P. van der; Vree, B.P.W. de; Meer, J.W.M. van der; Bleijenberg, G.

    2002-01-01

    OBJECTIVE: The aim of this study was to assess the potential influence of body consciousness and levels of somatic symptom report upon information processing speed in patients with chronic fatigue syndrome (CFS). BACKGROUND: According to a model of a fixed information processing capacity, it was pre

  1. The association of serum procalcitonin and high-sensitivity C-reactive protein with pneumonia in elderly multimorbid patients with respiratory symptoms: retrospective cohort study

    OpenAIRE

    Nouvenne, Antonio; Ticinesi, Andrea; Folesani, Giuseppina; Cerundolo, Nicoletta; Prati, Beatrice; Morelli, Ilaria; Guida, Loredana; Lauretani, Fulvio; Maggio, Marcello; Aloe, Rosalia; Lippi, Giuseppe; Meschi, Tiziana

    2016-01-01

    Background Serum procalcitonin and high-sensitivity C-reactive protein (hs-CRP) elevations have been associated with pneumonia in adults. Our aim was to establish their diagnostic usefulness in a cohort of hospitalized multimorbid patients ≥65 years old admitted to hospital with acute respiratory symptoms. Methods With a retrospective cohort study design, all multimorbid patients ≥65 years-old with acute respiratory symptoms admitted to an internal medicine hospital ward in Italy from January...

  2. A Cohort Study on Self-Reported Respiratory Symptoms of Toner-Handling Workers: Cross-Sectional and Longitudinal Analysis from 2003 to 2008

    OpenAIRE

    2014-01-01

    This study examines the relationship between toner-handling work and its health effects on self-reported respiratory symptoms. The subjects were 1,504 male workers in a Japanese toner and photocopier manufacturing company. Personal exposure measurement, pulmonary function tests, chest X-ray examination, measurement of biomarkers, and a questionnaire about self-reported respiratory symptoms were performed annually. This study discusses the questionnaire results. We found that the toner-handlin...

  3. A Randomized Controlled Trial of Qigong Exercise on Fatigue Symptoms, Functioning, and Telomerase Activity in Persons with Chronic Fatigue or Chronic Fatigue Syndrome

    OpenAIRE

    Ho, Rainbow T. H.; Chan, Jessie S. M.; Wang, Chong-Wen; Lau, Benson W. M.; So, Kwok Fai; Yuen, Li Ping; Sham, Jonathan S. T.; Chan, Cecilia L. W.

    2012-01-01

    BACKGROUND: Chronic fatigue is common in the general population. Complementary therapies are often used by patients with chronic fatigue or chronic fatigue syndrome to manage their symptoms. PURPOSE: This study aimed to assess the effect of a 4-month qigong intervention program among patients with chronic fatigue or chronic fatigue syndrome. METHODS: Sixty-four participants were randomly assigned to either an intervention group or a wait list control group. Outcome measures included fatigue s...

  4. [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

  5. Focused cardiac ultrasound in the emergency department for patients admitted with respiratory symptoms

    DEFF Research Database (Denmark)

    Laursen, C. B.

    2015-01-01

    In patients admitted with respiratory failure, a large proportion is diagnosed incorrectly in the emergency department and an even larger proportion seems to receive inappropriate treatment. Inappropriate initial treatment of these patients in the emergency department is associated with increased...

  6. Respiratory viral infections in infants:causes, clinical symptoms, virology, and immunology

    OpenAIRE

    Tregoning, John S; Schwarze, Jürgen

    2010-01-01

    In global terms, respiratory viral infection is a major cause of morbidity and mortality. Infancy, in particular, is a time of increased disease susceptibility and severity. Early-life viral infection causes acute illness and can be associated with the development of wheezing and asthma in later life. The most commonly detected viruses are respiratory syncytial virus (RSV), rhinovirus (RV), and influenza virus. In this review we explore the complete picture from epidemiology and virology to c...

  7. Comparison of Sinonasal Symptoms in Patients with Nasal Septal Deviation and Patients with Chronic Rhinosinusitis

    Directory of Open Access Journals (Sweden)

    Mohammad Naeimi

    2013-01-01

    Full Text Available Introduction: Disorders of the nose and paranasal sinuses are among the most common chronic illnesses. Although considerable progress has been made in the medical and surgical control of these diseases, a large number of questions relating to the diagnosis, evaluation, and treatment of these conditions remain unanswered. The aim of the present study was to evaluate differences in the frequency of symptoms and disease severity in patients with nasal septal deviation (NSD compared with chronic rhinosinusitis (CRS.  Materials and Methods: A total of 156 patients, divided into NSD and CRS groups, were studied in relation to symptoms and disease severity. Patients were selected from those referred to the Ear, Nose, and Throat (ENT Wards of the Imam Reza and Ghaem Hospitals, who had not responded to a variety of treatments. Depending on the type of disease, patients were candidates for either septoplasty or endoscopic sinus surgery. The Rhinosinusitis Symptom Inventory was administered to measure the severity of symptoms, with scores assigned based on the answers given by patients (Likert scale.  Scores were compared between the CRS and NSD groups.  Results: A total of 156 patients (78 with NDS and 78 with CRS entered the study in overall sinonasal symptoms were more prevalent in CRS group. Nasal congestion, runny nose, earache, toothache, and smelling disorder were significantly more common in the CRS group (P0.05.  Conclusion:  Patients with CRS manifested statistically significantly greater sinonasal symptom scores than patients with NSD.

  8. 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.

  9. 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

  10. Respiratory symptoms, lung function and particulate matter pollution in residential indoor environment in Ile-Ife, Nigeria

    Directory of Open Access Journals (Sweden)

    Lawrence I Ibhafidon

    2014-01-01

    Full Text Available Introduction: Particulate air pollution is associated with increased incidence of respiratory symptoms and decreased pulmonary, function but the relative impact of pollution from different domestic energy sources is not well-known or studied. Aim: The study was aimed at assessing the association between particulate concentrations, respiratory symptoms and lung function. Materials and Methods: It was a cross-sectional study comprised of randomly selected residents of three communities. These communities were selected according to the predominant type of fuel used for household cooking which were: firewood, kerosene and liquefied petroleum gas (LPG. Assessment of the indoor PM 10 levels was done by filtration using the Gent stacked filter unit sampler for collection of atmospheric aerosol in two size fractions (PM 2.5 and PM 10 . The Medical Research Council (MRC questionnaire was administered followed by spirometry test. Results: The mean PM 10 concentration in participants using LPG, kerosene and firewood was 80.8 ± 9.52 μg/m [3] , 236.9 ± 26.5 μg/m [3] and 269 ±93.7 μg/m [3] , respectively. The mean age and height-adjusted percent predicted forced expiratory volumes in 1 s (FEV1 for men were 127 ± 7, 109 ± 40 and 91 ± 20 and for women were 129 ± 13, 115 ± 14, 100 ± 14 in users of LPG, kerosene and firewood, respectively. A similar trend was found in the forced vital capacity (FVCs. Users of firewood had significantly lower FEV1 and FVC compared with LPG users (P < 0.05. The participants using firewood had the highest prevalence of pulmonary and non-pulmonary symptoms (57.1%, whereas subjects using LPG had the lowest (23.8%. Conclusion: There are high levels of particulate matter pollutions with respiratory effects in residential indoor environments in Ile-Ife, Nigeria

  11. Risco aumentado de sintomas respiratórios e bronquite crônica em mulheres que utilizam biocombustíveis na Nigéria Increased risk of respiratory symptoms and chronic bronchitis in women using biomass fuels in Nigeria

    OpenAIRE

    Olufemi Olumuyiwa Desalu; Adebowale Olayinka Adekoya; Bolawale Adedeji Ampitan

    2010-01-01

    OBJETIVO: Determinar a associação de sintomas respiratórios e bronquite crônica com o uso de biocombustíveis entre mulheres habitantes de áreas rurais do estado de Ekiti, sudoeste da Nigéria. MÉTODOS: De janeiro a junho de 2009, realizou-se um estudo transversal com uma amostra de 269 mulheres adultas. Um questionário adaptado do European Community Respiratory Health Survey foi aplicado para a obtenção de dados sobre características sociodemográficas, tipo de combustível utilizado para a prep...

  12. Iraq and Afghanistan Veterans report symptoms consistent with chronic multisymptom illness one year after deployment

    Directory of Open Access Journals (Sweden)

    Lisa M. McAndrew, PhD

    2016-02-01

    Full Text Available Many Veterans returning from service in Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF experience chronic pain. What is not known is whether for some OIF/OEF Veterans this pain is part of a larger condition of diffuse multisystem symptoms consistent with chronic multisymptom illness (CMI. We use data from a prospective longitudinal study of OIF/OEF Veterans to determine the frequency of CMI. We found that 1 yr after deployment, 49.5% of OIF/OEF Veterans met criteria for mild to moderate CMI and 10.8% met criteria for severe CMI. Over 90% of Veterans with chronic pain met criteria for CMI. CMI was not completely accounted for either by posttraumatic stress disorder or by predeployment levels of physical symptoms. Veterans with symptoms consistent with CMI reported significantly worse physical health function than Veterans who did not report symptoms consistent with CMI. This study suggests that the presence of CMI should be considered in the evaluation of OIF/OEF Veterans. Further, it suggests that the pain management for these Veterans may need to be tailored to take CMI into consideration.

  13. Chronic gastrointestinal symptoms and quality of life in the Korean population

    Institute of Scientific and Technical Information of China (English)

    Jeong-Jo Jeong; Sok-Won Han; Kyu-Yong Choi; In-Sik Chung; Myung-Gyu Choi; Young-Seok Cho; Seung-Geun Lee; Jung-Hwan Oh; Jae-Myung Park; Yu-Kyung Cho; In-Seok Lee; Sang-Woo Kim

    2008-01-01

    AIM: To evaluate the prevalence of chronic gastroin-testinal symptoms and their impact on health-related quality of life (HRQOL) in the Korean population. METHODS: A cross-sectional survey, using a reliable and valid Rome 1I based questionnaire, was per-formed on randomly selected residents, between 18 and 69 years in age. All respondents were interviewed at their homes or offices by a team of interviewers. The impact of chronic gastrointestinal symptoms on HRQOL was assessed using the Korean version of the 36-item Short-Form general health survey (SF-36). RESULTS: Of the 1807 eligible subjects, 1417 (78.4%: male 762; female 655) were surveyed. Out of the respondents, 18.6% exhibited at least one chronic gastrointestinal symptom. The prevalence of gastro-esophageal reflux disease (GERD), defined as heart-burn and/or acid regurgitation experienced at least weekly, was 3.5% (95% CI, 2.6-4.5). The prevalence of uninvestigated dyspepsia, irritable bowel syndrome (IBS) and chronic constipation based on Rome Ⅱ cri-teria were 11.7% (95% CI, 10.1-13.5), 2.2% (95% CI, 1.5-3.1), and 2.6% (95% CI, 1.8-3.5) respectively. Compared with subjects without chronic gastrointesti-nal symptoms (n = 1153), those with GERD (n = 50), uninvestigated dyspepsia (n = 166) and IBS (n=31) had significantly worse scores on most domains of the SF-36 scales. CONCLUSION: The prevalence of GERD, uninvesti-gated dyspepsia and IBS were 3.5%, 11.7% and 2.2% respectively, in the Korean population. The health-related quality of life was significantly impaired in sub-jects with GFRD, uninvestigated dyspepsia and IBS in this community.

  14. 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...

  15. Longitudinal associations of depressive symptoms and pain with quality of life in patients receiving chronic hemodialysis.

    Science.gov (United States)

    Belayev, Linda Y; Mor, Maria K; Sevick, Mary Ann; Shields, Anne Marie; Rollman, Bruce L; Palevsky, Paul M; Arnold, Robert M; Fine, Michael J; Weisbord, Steven D

    2015-04-01

    Depressive symptoms and pain are common in patients on chronic hemodialysis (HD), yet their associations with quality of life (QOL) are not fully understood. We sought to characterize the longitudinal associations of these symptoms with QOL. As part of a trial comparing two symptom management strategies in patients receiving chronic HD, we assessed depressive symptoms using the Patient Health Questionnaire-9 (PHQ-9), and pain using the Short Form McGill Pain Questionnaire (SF-MPQ) monthly over 24 months. We assessed health-related QOL (HR-QOL) quarterly using the Short Form 12 (SF-12) and global QOL (G-QOL) using a single-item survey. We used random effects linear regression to analyze the independent associations of depressive symptoms and pain, scaled based on 5-point increments in symptom scores, with HR-QOL and G-QOL. Overall, 286 patients completed 1417 PHQ-9 and SF-MPQ symptom assessments, 1361 SF-12 assessments, and 1416 G-QOL assessments. Depressive symptoms were independently and inversely associated with SF-12 physical HR-QOL scores (β = -1.09; 95% confidence interval [CI]: -1.69, -0.50, P < 0.001); SF-12 mental HR-QOL scores (β = -4.52; 95% CI: -5.15, -3.89, P < 0.001); and G-QOL scores (β = -0.64; 95%CI: -0.79, -0.49, P < 0.001). Pain was independently and inversely associated with SF-12 physical HR-QOL scores (β = -0.99; 95% CI: -1.30, -0.68, P < 0.001) and G-QOL scores (β = -0.12; 95%CI: -0.20, -0.05, P = 0.002); but not with SF-12 mental HR-QOL scores (β = -0.16; 95%CI: -0.050, 0.17, P = 0.34). In patients receiving chronic HD, depressive symptoms and to a lesser extent pain, are independently associated with reduced HR-QOL and G-QOL. Interventions to alleviate these symptoms could potentially improve patients' HR-QOL and G-QOL.

  16. 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.

  17. Sudden Visual Deterioration as the First Symptom of Chronic Kidney Failure

    Directory of Open Access Journals (Sweden)

    Weronika Pociej-Marciak

    2015-11-01

    Full Text Available Purpose: We report here a unique case of a sudden loss of vision as the first symptom of an advanced chronic nephropathy. Methods and Results: A 25-year-old man was referred to the Department of Ophthalmology with sudden visual deterioration presumptively diagnosed as bilateral retinitis. The patient had never been under any medical care before and had never had any clinical signs of any chronic disease. He underwent an ophthalmic examination with optical coherence tomography (OCT. Based on the clinical features, OCT scans and systemic blood pressure (BP assessment (225/145 mm Hg, the patient was definitely diagnosed with hypertensive retinopathy and choroidopathy due to hypertensive crisis. After urgent diagnostic procedures, the patient was diagnosed with a chronic kidney disease at stage 5 in the course of chronic glomerulonephritis. Immediately, a renal replacement therapy was started and the patient was qualified for renal transplantation. Conclusion: Adolescents with an unclear picture of retinal lesions, who have neither a history nor clinical signs of a systemic disease, should undergo careful systemic screening with BP assessment. A sudden deterioration of vision may be the first symptom of a previously undiagnosed severe systemic disease (very rare chronic that requires immediate treatment.

  18. 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.

  19. Respiratory muscle pacing with chronically implanted intramuscular Permaloc electrodes: A feasibility study

    Directory of Open Access Journals (Sweden)

    James S. Walter, PhD

    2011-02-01

    Full Text Available We tested the feasibility of stimulating upper-intercostal and abdominal muscles plus the diaphragm by using chronically implanted intramuscular electrodes. During two survival surgeries with six dogs, intramuscular electrodes were implanted bilaterally in the three respiratory muscles. Standard stimulation of the diaphragm was conducted. The dorsolateral and ventrolateral abdominal wall areas were stimulated with a 25 mA current. The second to fourth intercostal spaces were stimulated to elicit the largest tidal volume associated with the least coactivation of the serratus and latissimus muscles. Lone diaphragm and upper-intercostal muscle pacing produced inhaled tidal volumes (mean +/- standard error of the mean of 293 +/- 36 mL and 59 +/- 17 mL, respectively. Lone abdominal muscle pacing produced an exhaled volume of 55 +/- 17 mL. Combined pacing of diaphragm and intercostal muscles increased the inhaled volume to 389 +/- 39 mL. The addition of abdominal pacing following the combined stimulation of diaphragm and intercostals increased the exhaled volume to 472 +/- 54 mL. During autopsy, dislodgement of the electrodes overlying the ribs was a concern and probably resulted from loose animal jackets. Chronic intramuscular Permaloc electrodes can be implanted in several respiratory muscles and increase tidal volumes more than diaphragm stimulation alone.

  20. Daily changes of peak expiratory flow and respiratory symptom occurrence around a soy processing factory

    NARCIS (Netherlands)

    Heederik, Dick; Doekes, Gert; van Strien, Rob; Brunekreef, Bert

    2014-01-01

    Objectives. To evaluate sensitization and acute respiratory health effects in inhabitants living in the vicinity of a factory producing soy oil. Methods. Two panels of potential responders were created on the basis of a response to a short screening questionnaire sent to random samples of 1,000 expo

  1. 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...

  2. 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...

  3. Relationship among nausea, anxiety, and orthostatic symptoms in pediatric patients with chronic unexplained nausea.

    Science.gov (United States)

    Tarbell, Sally E; Shaltout, Hossam A; Wagoner, Ashley L; Diz, Debra I; Fortunato, John E

    2014-08-01

    This study evaluated the relationship among nausea, anxiety, and orthostatic symptoms in pediatric patients with chronic unexplained nausea. We enrolled 48 patients (36 females) aged 15 ± 2 years. Patients completed the Nausea Profile, State-Trait Anxiety Inventory for Children and underwent 70° head upright tilt testing (HUT) to assess for orthostatic intolerance (OI) and measure heart rate variability (HRV). We found nausea to be significantly associated with trait anxiety, including total nausea score (r = 0.71, p Nausea was positively associated with state anxiety, total nausea (r = 0.55, p Nausea reported on the Nausea Profile before HUT was associated with OI measured at 10 min of tilt (nausea total r = 0.35, p nausea emotional subscale r = 0.40, p nausea is associated with both anxiety symptoms and OI. The finding of decreased HRV suggests an underlying problem in autonomic nervous system function in children and adolescents with chronic unexplained nausea.

  4. Lower back pain - silent symptom of chronic infrarenal abdominal aneurysm rupture

    Directory of Open Access Journals (Sweden)

    Juković Mirela

    2016-01-01

    Full Text Available Introduction. The rupture of infrarenal abdominal aortic aneurysm is a surgical emergency condition with a high rate of mortality before the patients arrive at hospital. The signs and symptoms of abdominal aortic aneurysm rupture into the retroperitoneal cavity are pulsatile mass, abdominal pain, hypotension and shock, but sometimes silent symptoms also hide a dangerous and life threatening condition, such as chronic aneurysm rupture of abdominal aorta into the retroperitoneal cavity. Case Report. We present a patient having had the lower back pain for 4 months, which had been recognized and treated as lumbar ischialgia but which was eventually diagnosed to be chronic infrarenal abdominal aortic aneurysm rupture by computed tomography angiography. The surgical intervention was successful and the patient was discharged from hospital after 6 days without any clinical complications. Preoperative imaging by computed tomography angiography of ruptured abdominal aortic aneurysm is highly sensitive for detection of several specific signs for rupture. This condition leads to urgent vascular surgery.

  5. Functional Neurological Symptom Disorder: Mismanagement, Misdiagnosis, Chronic Cough Following Sexual Abuse: A Rare Case Report.

    Science.gov (United States)

    Bidaki, Reza; Zarepur, Ehsan; Akrami, Maryam; Mohammad, Mohammad

    2016-01-01

    Objective Conversion disorder (CD) is a mental disorder in which patient displays neurological symptoms such as blindness, mutism, paralysis and seizure. It starts when our mind converts our mental stress into a physical symptom. A 15-year-old single white female with chronic cough, which had begun 5 months ago, was brought to our clinic. She had no history of hospitalization. His daily cough was without sputum production or fever, rhinorrhea and stopped during sleep. There was no recent exposure to tobacco smoke or a person with a chronic productive cough. Laboratory tests were normal. She had engaged 4 months ago. Doing sex during engagement is prohibited in her culture but and had anal sex, because of her spouse's trend. Psychotherapy was done and complete recovery was accomplished. PMID:27247590

  6. Functional Neurological Symptom Disorder: Mismanagement, Misdiagnosis, Chronic Cough Following Sexual Abuse: A Rare Case Report

    Science.gov (United States)

    BIDAKI, Reza; ZAREPUR, Ehsan; AKRAMI, Maryam; Mohammad, Mohammad

    2016-01-01

    Objective Conversion disorder (CD) is a mental disorder in which patient displays neurological symptoms such as blindness, mutism, paralysis and seizure. It starts when our mind converts our mental stress into a physical symptom. A 15-year-old single white female with chronic cough, which had begun 5 months ago, was brought to our clinic. She had no history of hospitalization. His daily cough was without sputum production or fever, rhinorrhea and stopped during sleep. There was no recent exposure to tobacco smoke or a person with a chronic productive cough. Laboratory tests were normal. She had engaged 4 months ago. Doing sex during engagement is prohibited in her culture but and had anal sex, because of her spouse’s trend. Psychotherapy was done and complete recovery was accomplished. PMID:27247590

  7. Salivary Amylase Level in Bronchoalveolar Fluid as a Marker of Chronic Pulmonary Aspiration in Children

    OpenAIRE

    Abu-Hasan, Mutasim; Elmallah, Mai; Neal, Dan; Brookes, James

    2014-01-01

    Background: Chronic pulmonary aspiration is a common cause of chronic respiratory symptoms in children. However, there is no gold standard diagnostic test for aspiration. In this study, we explore the diagnostic value of measuring salivary amylase in bronchoalveolar lavage (BAL) fluid as a marker of chronic aspiration in children with different chronic respiratory illnesses.

  8. Sleep Onset Insomnia Symptoms during Hospitalization for Major Burn Injury Predict Chronic Pain

    OpenAIRE

    Smith, Michael T; Klick, Brendan; Kozachik, Sharon; Edwards, Robert E.; Holavanahalli, Radha; Wiechman, Shelley; Blakeney, Patricia; Lezotte, Dennis; Fauerbach, James A.

    2008-01-01

    Both cross-sectional studies of chronic pain and sleep deprivation experiments suggest a bi-directional relationship between sleep and pain. Few longitudinal studies, however, have assessed whether acute-insomnia following traumatic injury predicts the development of persistent pain. We sought to evaluate: 1) whether in-hospital insomnia independently predicts long-term pain after burn injury and 2) whether in-hospital pain predicts future insomnia symptoms. We analyzed data on 333 subjects h...

  9. Depressive symptoms and perceived chronic stress predict test anxiety in nursing students

    OpenAIRE

    Christoph Augner

    2015-01-01

    Aim: The aim of this study is to identify predictors of test anxiety in nursing students. Design: Cross sectional pilot study. Methods: A questionnaire was administered to 112 students of an Austrian nursing school (mean age = 21.42, SD = 5.21). Test anxiety (measured by the standardized PAF Test Anxiety Questionnaire), perceived chronic stress, depressive symptoms, pathological eating and further psychological and health parameters were measured. Results: We found highly significant correlat...

  10. Farmer's Lung: Causes and Symptoms of Mold and Dust Induced Respiratory Illness

    Science.gov (United States)

    ... Skip Menu Main Content Publications and Educational Resources Farmer's Lung: Causes and Symptoms of Mold and Dust ... This Publication is available in a PDF format Farmer’s lung is a noninfectious allergic disease that is ...

  11. Avaliação da concentração de alfa 1-antitripsina e da presença dos alelos S e Z em uma população de indivíduos sintomáticos respiratórios crônicos Determination of alpha 1-antitrypsin levels and of the presence of S and Z alleles in a population of patients with chronic respiratory symptoms

    Directory of Open Access Journals (Sweden)

    Heliane Guerra Serra

    2008-12-01

    Full Text Available OBJETIVO: Determinar a concentração de alfa 1-antitripsina (AAT e a prevalência dos alelos S e Z em indivíduos sintomáticos respiratórios crônicos. MÉTODOS: Pacientes com tosse crônica e dispnéia foram submetidos à avaliação clínica, espirometria, tomografia computadorizada de tórax, dosagem de AAT por nefelometria e pesquisa das mutações S e Z por reação em cadeia da polimerase. Foram consideradas como variáveis dependentes a concentração de AAT e o tabagismo. RESULTADOS: Dos 89 pacientes incluídos no estudo (44 mulheres; idade média, 51,3 ± 18,2 anos, os alelos S e Z foram detectados em 33,3% e 5,7%, respectivamente, com freqüência gênica dos alelos S e Z de 0,16 e 0,028. Dois pacientes tinham genótipo SZ (AAT 141 mg/dL (normal, Grupo 2, n = 57. A freqüência de fumantes foi igual nos dois grupos, com carga tabágica maior no Grupo 2. O alelo S estava presente em 13 e 14 pacientes dos Grupos 1 e 2, respectivamente, enquanto que o alelo Z estava presente em 2 e 1 paciente dos mesmos grupos. Não houve diferença nos testes de função pulmonar, nem na freqüência de bronquiectasias ou enfisema entre os dois grupos. Os valores espirométricos e as concentrações de AAT foram similares entre fumantes e não-fumantes. Bronquiectasias foram mais freqüentes entre os não fumantes, e enfisema foi mais freqüente entre os fumantes. CONCLUSÕES: Trinta pacientes apresentaram níveis de AAT abaixo da média esperada para os genótipos MM e MS, e este fato não pode ser explicado por uma freqüência maior dos alelos S e Z.OBJECTIVE: To determine the levels of alpha-1 antitrypsin (AAT and the presence of S and Z alleles in patients with chronic respiratory symptoms. METHODS: Patients with chronic cough and dyspnea were submitted to clinical evaluation, pulmonary function tests, high-resolution computed tomography, nephelometric determination of AAT and determination of S and Z alleles by polymerase chain reaction. Smoking

  12. Occupational exposure to pesticides and respiratory health

    OpenAIRE

    Ali Mamane; Isabelle Baldi; Jean-François Tessier; Chantal Raherison; Ghislaine Bouvier

    2015-01-01

    This article aims to review the available literature regarding the link between occupational exposure to pesticides and respiratory symptoms or diseases. Identification of epidemiological studies was performed using PubMed. 41 articles were included, 36 regarding agricultural workers and five regarding industry workers. Among the 15 cross-sectional studies focusing on respiratory symptoms and agricultural pesticide exposure, 12 found significant associations with chronic cough, wheeze, dyspno...

  13. Prevalence of Ocular, Respiratory and Cutaneous Symptoms in Indoor Swimming Pool Workers and Exposure to Disinfection By-Products (DBPs

    Directory of Open Access Journals (Sweden)

    Guglielmina Fantuzzi

    2010-03-01

    Full Text Available The objective of this cross-sectional study was to investigate the prevalence of self-reported respiratory, ocular and cutaneous symptoms in subjects working at indoor swimming pools and to assess the relationship between frequency of declared symptoms and occupational exposure to disinfection by-products (DBPs. Twenty indoor swimming pools in the Emilia Romagna region of Italy were included in the study. Information about the health status of 133 employees was collected using a self-administered questionnaire. Subjects working at swimming pools claimed to frequently experience the following symptoms: cold (65.4%, sneezing (52.6%, red eyes (48.9% and itchy eyes (44.4%. Only 7.5% claimed to suffer from asthma. Red eyes, runny nose, voice loss and cold symptoms were declared more frequently by pool attendants (lifeguards and trainers when compared with employees working in other areas of the facility (office, cafe, etc.. Pool attendants experienced generally more verrucas, mycosis, eczema and rash than others workers; however, only the difference in the frequency of self-declared mycosis was statistically significant (p = 0.010. Exposure to DBPs was evaluated using both environmental and biological monitoring. Trihalomethanes (THMs, the main DBPs, were evaluated in alveolar air samples collected from subjects. Swimming pool workers experienced different THM exposure levels: lifeguards and trainers showed the highest mean values of THMs in alveolar air samples (28.5 ± 20.2 µg/m3, while subjects working in cafe areas (17.6 ± 12.1 µg/m3, offices (14.4 ± 12.0 µg/m3 and engine rooms (13.6 ± 4.4 µg/m3 showed lower exposure levels. Employees with THM alveolar air values higher than 21 µg/m3 (median value experienced higher risks for red eyes (OR 6.2; 95% CI 2.6–14.9, itchy eyes (OR 3.5; 95% CI 1.5–8.0, dyspnea/asthma (OR 5.1; 95% CI 1.0–27.2 and blocked nose (OR 2.2; 95% CI 1.0–4.7 than subjects with less exposure. This study confirms

  14. Prevalence of ocular, respiratory and cutaneous symptoms in indoor swimming pool workers and exposure to disinfection by-products (DBPs).

    Science.gov (United States)

    Fantuzzi, Guglielmina; Righi, Elena; Predieri, Guerrino; Giacobazzi, Pierluigi; Mastroianni, Katia; Aggazzotti, Gabriella

    2010-04-01

    The objective of this cross-sectional study was to investigate the prevalence of self-reported respiratory, ocular and cutaneous symptoms in subjects working at indoor swimming pools and to assess the relationship between frequency of declared symptoms and occupational exposure to disinfection by-products (DBPs). Twenty indoor swimming pools in the Emilia Romagna region of Italy were included in the study. Information about the health status of 133 employees was collected using a self-administered questionnaire. Subjects working at swimming pools claimed to frequently experience the following symptoms: cold (65.4%), sneezing (52.6%), red eyes (48.9%) and itchy eyes (44.4%). Only 7.5% claimed to suffer from asthma. Red eyes, runny nose, voice loss and cold symptoms were declared more frequently by pool attendants (lifeguards and trainers) when compared with employees working in other areas of the facility (office, cafe, etc.). Pool attendants experienced generally more verrucas, mycosis, eczema and rash than others workers; however, only the difference in the frequency of self-declared mycosis was statistically significant (p = 0.010). Exposure to DBPs was evaluated using both environmental and biological monitoring. Trihalomethanes (THMs), the main DBPs, were evaluated in alveolar air samples collected from subjects. Swimming pool workers experienced different THM exposure levels: lifeguards and trainers showed the highest mean values of THMs in alveolar air samples (28.5 +/- 20.2 microg/m(3)), while subjects working in cafe areas (17.6 +/- 12.1 microg/m(3)), offices (14.4 +/- 12.0 microg/m(3)) and engine rooms (13.6 +/- 4.4 microg/m(3)) showed lower exposure levels. Employees with THM alveolar air values higher than 21 microg/m(3) (median value) experienced higher risks for red eyes (OR 6.2; 95% CI 2.6-14.9), itchy eyes (OR 3.5; 95% CI 1.5-8.0), dyspnea/asthma (OR 5.1; 95% CI 1.0-27.2) and blocked nose (OR 2.2; 95% CI 1.0-4.7) than subjects with less exposure

  15. Child sex and respiratory sinus arrhythmia reactivity as moderators of the relation between internalizing symptoms and aggression.

    Science.gov (United States)

    Aults, Christopher D; Cooper, Patrick J; Pauletti, Rachel E; Jones, Nancy Aaron; Perry, David G

    2015-12-01

    Previous studies have examined sex differences in physiological responding, including respiratory sinus arrhythmia (RSA) reactivity in response to changing stimulus conditions involving situation specific or gender related cues, in children and adolescents. The present study examined whether RSA reactivity moderates the relation between aggression and internalizing symptoms and whether there are sex differences in this effect. Participants were 82 adolescents (M age = 12.1 years; 44 girls) from the general middle-school population. Peer nominations assessed aggression and internalizing symptoms, and RSA reactivity (defined as change in RSA from baseline to task) was recorded while participants anticipated and responded to an 85 dB signaled white-noise burst. For girls, internalizing symptoms were associated with aggression only if girls showed low RSA reactivity from baseline to task; there was no effect for boys. This association was absent when girls showed high RSA reactivity. Thus, child sex appears to influence not only levels of physiological responding but also relations of physiological responding to comorbidity of adjustment problems.

  16. The relationship of glutathione-S-transferases copy number variation and indoor air pollution to symptoms and markers of respiratory disease

    DEFF Research Database (Denmark)

    Hersoug, Lars-Georg; Brasch-Andersen, Charlotte; Husemoen, Lise-Lotte;

    2012-01-01

    : To investigate whether deletions of GSTM1 and GSTT1 modify the potential effects of exposure to indoor sources of PM on symptoms and objective markers of respiratory disease. Methods: We conducted a population-based, cross-sectional study of 3471 persons aged 18-69 years. Information about exposure to indoor......: We found that none of the symptoms and objective markers of respiratory disease were significantly associated with the GST null polymorphisms. An increasing number of positive alleles of the GSTM1 polymorphism tended to be associated lower prevalence of wheeze, cough, and high forced expiratory....... The relationship of glutathione-S-transferases copy number variation and indoor air pollution to symptoms and markers of respiratory disease. Clin Respir J 2011; DOI:10.1111/j.1752-699X.2011.00258.x....

  17. Lipid-Laden Alveolar Macrophages and pH Monitoring in Gastroesophageal Reflux-Related Respiratory Symptoms

    Directory of Open Access Journals (Sweden)

    R. Kitz

    2012-01-01

    Full Text Available Lipid-laden alveolar macrophages and pH monitoring have been used in the diagnosis of chronic aspiration in children with gastroesophageal reflux (GER. This study was conducted to prove a correlation between the detection of alimentary pulmonary fat phagocytosis and an increasing amount of proximal gastroesophageal reflux. It was assumed that proximal gastroesophageal reflux better correlates with aspiration than distal GER. Patients from 6 months to 16 years with unexplained recurrent wheezy bronchitis and bronchial hyperreactivity, or recurrent pneumonia with chronic cough underwent 24-hour double-channel pH monitoring and bronchoscopy with bronchoalveolar lavage (BAL. Aspiration of gastric content was determined by counting lipid laden alveolar macrophages from BAL specimens. There were no correlations between any pH-monitoring parameters and counts of lipid-laden macrophages in the whole study population, even when restricting analysis to those with abnormal reflux index expressing clinically significant GER. Quantifying lipid-laden alveolar macrophages from BAL in children with gastroesophageal-related respiratory disorders does not have an acceptable specificity to prove chronic aspiration as an underlying etiology. Therefore, research for other markers of pulmonary aspiration is needed.

  18. Respiratory Symptoms and Lung Function among Danish Construction Workers. A Cross-Sectional Study

    DEFF Research Database (Denmark)

    Hanskov, Dorte Jessing Agerby; Brauer, Charlotte; Breinegaard, Nina;

    2015-01-01

    Objective:This study investigated whether Danish construction workers had an increased prevalence of chronic obstructive pulmonary disease (COPD) or affected lung function and if the prevalence differed between types of jobs within construction. Methods:A cross-sectional study of 899 Danish male ...

  19. A pilot study on acupuncture for lower urinary tract symptoms related to chronic prostatitis/chronic pelvic pain

    Directory of Open Access Journals (Sweden)

    Stone Brian A

    2007-02-01

    Full Text Available Abstract Background The etiology and treatment of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS remain poorly understood. Pain, lower urinary tract voiding symptoms and negative impact on quality of life (QOL are the most common complaints. Acupuncture, which has been widely used to treat painful and chronic conditions, may be a potential treatment to alleviate the constellation of symptoms experienced by men with CP/CPPS. The purpose of our study was to assess the impact of standardized full body and auricular acupuncture in men refractory to conventional therapies and collect pilot data to warrant further randomized trials. Methods Ten men diagnosed with category IIIA or IIIB CP/CPPS >6 months, refractory to at least 1 conventional therapy (antibiotics, anti-inflammatory agents, 5-α reductase inhibitors, α-1 blockers and scoring >4 on the pain subset of the NIH-CPSI were prospectively analyzed in an Institutional Review Board (IRB approved, single-center clinical trial (Columbia University Medical Center IRB#AAAA-7460. Standardized full body and auricular acupuncture treatment was given twice weekly for 6 weeks. The primary endpoints were total score of the NIH-CPSI and assessment of serious adverse events. The secondary endpoints were individual scores of the NIH-CPSI and QOL questionnaire scores of the short-form 36 (SF-36. Results The median age of the subjects was 36 years (range 29–63. Decreases in total NIH-CPSI scores (mean ± SD after 3 and 6 weeks from baseline (25.1 ± 6.6 were 17.6 ± 5.7 (P Conclusion The preliminary findings, although limited, suggest the potential therapeutic role of acupuncture in the treatment of CP/CPPS. Data from this and previous studies warrant randomized trials of acupuncture for CP/CPPS and particular attention towards acupuncture point selection, treatment intervention, and durability of acupuncture.

  20. Reported Respiratory Symptom Intensity in Asthmatics During Exposure to Aerosolized Florida Red Tide Toxins

    OpenAIRE

    Milian, Alexyz; Nierenberg, Kate; Fleming, Lora E.; Bean, Judy A.; Wanner, Adam; Reich, Andrew; Backer, Lorraine C.; Jayroe, David; Kirkpatrick, Barbara

    2007-01-01

    Florida red tides are naturally occurring blooms of the marine dinoflagellate, Karenia brevis. K. brevis produces natural toxins called brevetoxins. Brevetoxins become part of the marine aerosol as the fragile, unarmored cells are broken up by wave action. Inhalation of the aerosolized toxin results in upper and lower airway irritation. Symptoms of brevetoxin inhalation include: eye, nose, and throat irritation, coughing, wheezing, chest tightness, and shortness of breath. Asthmatics appear t...

  1. Detection and differentiation of Mycoplasma gallisepticum and Mycoplasma synoviaeby PCR from tracheal swabs from birds with respiratory symptoms

    International Nuclear Information System (INIS)

    Mycoplasmas are worldwide pathogens that affect the poultry industry causing respiratory illness which cause a negative economic impact. Two mycoplasmas species are the most important in the commercial poultry: mycoplasma gallisepticum (MG) and mycoplasma synoviae (MS). By its importance and necessity to know and differentiate between mycoplasmas species in local's poultry houses this study used the PCR technique like a diagnosis tool, using tracheal swabs from bird with respiratory symptoms. A total of 91 samples from broilers, layers and breeders farms located in the departments of Cundinamarca and Boyaca was processed. The punctual prevalence founded in this study was 39.6 % for mg and 47.3 % for MS. statistical differences for type of production and positive samples for mg y MS (p < 0.05) were founded, a bigger number of positive samples from layers and breeder in comparison to broilers were found. In the same way, the positive samples for the layers and breeder from the age group between 20 and 60 weeks was greater, while for the broilers group most of the positive samples were from five weeks old birds for mg and two weeks old birds for MS.

  2. Respiratory viral infections and effects of meteorological parameters and air pollution in adults with respiratory symptoms admitted to the emergency room

    OpenAIRE

    Silva, Denise R.; Viana, Vinícius P; Müller, Alice M; Livi, Fernando P; Dalcin, Paulo de Tarso R

    2013-01-01

    Background Respiratory viral infections (RVIs) are the most common causes of respiratory infections. The prevalence of respiratory viruses in adults is underestimated. Meteorological variations and air pollution are likely to play a role in these infections. Objectives The objectives of this study were to determine the number of emergency visits for influenza-like illness (ILI) and severe acute respiratory infection (SARI) and to evaluate the association between ILI/SARI, RVI prevalence, and ...

  3. 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.

  4. Evaluating Symptoms to Improve Quality of Life in Patients with Chronic Stable Angina

    Directory of Open Access Journals (Sweden)

    Jeffrey W. Young

    2013-01-01

    Full Text Available Chronic stable angina (CSA is a significant problem in the United States that can negatively impact patient quality of life (QoL. An accurate assessment of the severity of a patient’s angina, the impact on their functional status, and their risk of cardiovascular complications is key to successful treatment of CSA. Active communication between the patient and their healthcare provider is necessary to ensure that patients receive optimal therapy. Healthcare providers should be aware of atypical symptoms of CSA in their patients, as patients may continue to suffer from angina despite the availability of multiple therapies. Patient questionnaires and symptom checklists can help patients communicate proactively with their healthcare providers. This paper discusses the prevalence of CSA, its impact on QoL, and the tools that healthcare providers can use to assess the severity of their patients’ angina and the impact on QoL.

  5. Connectome organization is related to longitudinal changes in general functioning, symptoms and IQ in chronic schizophrenia.

    Science.gov (United States)

    Collin, G; de Nijs, J; Hulshoff Pol, H E; Cahn, W; van den Heuvel, M P

    2016-06-01

    Emerging evidence suggests schizophrenia to involve widespread alterations in the macroscale wiring architecture of the human connectome. Recent findings of attenuated connectome alterations in unaffected siblings of schizophrenia patients suggest that altered connectome organization may relate to the vulnerability to develop the disorder, but whether it relates to progression of illness after disease onset is currently unknown. Here, we examined the interaction between connectome structure and longitudinal changes in general functioning, clinical symptoms and IQ in the 3years following MRI assessment in a group of chronically ill schizophrenia patients. Effects in patients were compared to associations between connectome organization and changes in subclinical symptoms and IQ in healthy controls and unaffected siblings of schizophrenia patients. Analyzing the patient sample revealed a relationship between structural connectivity-particularly among central 'brain hubs'-and progressive changes in general functioning (p=0.007), suggesting that more prominent impairments of hub connectivity may herald future functional decline. Our findings further indicate that affected local connectome organization relates to longitudinal increases in overall PANSS symptoms (p=0.013) and decreases in total IQ (p=0.003), independent of baseline symptoms and IQ. No significant associations were observed in controls and siblings, suggesting that the findings in patients represent effects of ongoing illness, as opposed to normal time-related changes. In all, our findings suggest connectome structure to have predictive value for the course of illness in schizophrenia. PMID:25843919

  6. The distressed (type D) personality is independently associated with impaired health status and increased depressive symptoms in chronic heart failure

    DEFF Research Database (Denmark)

    Schiffer, Angélique A; Pedersen, Susanne S.; Widdershoven, Jos W;

    2005-01-01

    Chronic heart failure (CHF) is a serious condition that is associated with impaired health status and a high prevalence of depressive symptoms. To date, little is known about the determinants of health status and depressive symptoms in CHF. Therefore, the aim of this study was to assess whether T...... Type D personality is associated with impaired health status and increased depressive symptoms in heart failure patients, independent of disease characteristics....

  7. Plasma neuropeptide Y: a biomarker for symptom severity in chronic fatigue syndrome

    Directory of Open Access Journals (Sweden)

    Harvey Jeanna M

    2010-12-01

    Full Text Available Abstract Background Chronic fatigue syndrome (CFS is a complex, multi-symptom illness with a multisystem pathogenesis involving alterations in the nervous, endocrine and immune systems. Abnormalities in stress responses have been identified as potential triggers or mediators of CFS symptoms. This study focused on the stress mediator neuropeptide Y (NPY. We hypothesized that NPY would be a useful biomarker for CFS. Methods The CFS patients (n = 93 were from the Chronic Fatigue and Related Disorders Clinic at the University of Miami and met the 1994 case definition of Fukuda and colleagues. Healthy sedentary controls (n = 100 were from NIH or VA funded studies. Another fatiguing, multi-symptom illness, Gulf War Illness (GWI, was also compared to CFS. We measured NPY in plasma using a radioimmunoassay (RIA. Psychometric measures, available for a subset of CFS patients included: Perceived Stress Scale, Profile of Mood States, ATQ Positive & Negative Self-Talk Scores, the COPE, the Beck Depression Inventory, Fatigue Symptom Inventory, Cognitive Capacity Screening Examination, Medical Outcomes Survey Short Form-36, and the Quality of Life Scale. Results Plasma NPY was elevated in CFS subjects, compared to controls (p = .000 and to GWI cases (p = .000. Receiver operating characteristics (ROC curve analyses indicated that the predictive ability of plasma NPY to distinguish CFS patients from healthy controls and from GWI was significantly better than chance alone. In 42 patients with CFS, plasma NPY had significant correlations ( Conclusions This study is the first in the CFS literature to report that plasma NPY is elevated compared to healthy controls and to a fatigued comparison group, GWI patients. The significant correlations of NPY with stress, negative mood, general health, depression and cognitive function strongly suggest that this peptide be considered as a biomarker to distinguish subsets of CFS.

  8. Chronic symptoms after vestibular neuritis and the high velocity vestibulo-ocular reflex

    Science.gov (United States)

    Patel, Mitesh; Arshad, Qadeer; Roberts, R Edward; Ahmad, Hena; Bronstein, Adolfo M.

    2015-01-01

    Hypothesis As the anterior and posterior semicircular canals are vital to the regulation of gaze stability, particularly during locomotion or vehicular travel, we tested whether the high velocity vestibulo-ocular reflex (VOR) of the three ipsilesional semicircular canals elicited by the modified Head Impulse Test would correlate with subjective dizziness or vertigo scores after vestibular neuritis (VN). Background Recovery following acute VN varies with around half reporting persistent symptoms long after the acute episode. However, an unanswered question is whether chronic symptoms are associated with impairment of the high velocity VOR of the anterior or posterior canals. Methods Twenty patients who had experienced an acute episode of VN at least three months earlier were included in this study. Participants were assessed with the video head impulse test (vHIT) of all six canals, bithermal caloric irrigation, the Dizziness Handicap Inventory (DHI) and the Vertigo Symptoms Scale short-form (VSS). Results Of these 20 patients, 12 felt that they had recovered from the initial episode whereas 8 did not and reported elevated DHI and VSS scores. However, we found no correlation between DHI or VSS scores and the ipsilesional single or combined vHIT gain, vHIT gain asymmetry or caloric paresis. The high velocity VOR was not different between patients who felt they had recovered and patients who felt they had not. Conclusions Our findings suggest that chronic symptoms of dizziness following VN are not associated with the high velocity VOR of the single or combined ipsilesional horizontal, anterior or posterior semicircular canals. PMID:26719963

  9. Respiratory, sensory and general health symptoms in populations exposed to air pollution from biodegradable wastes

    DEFF Research Database (Denmark)

    Blanes-Vidal, Victoria; Bælum, Jesper; Schwartz, Joel;

    ecological and did not investigate whether these potential associations were direct or indirect (stress-mediated). Methods: In this study, individual-specific exposures to a proxy indicator of biodegradable waste pollution (ammonia, NH3) in non-urban residences (n=454) during 2005-2010 were calculated...... exposure)). The results on mediation indicated indirect (annoyance-mediated) associations between exposures and increased occurrence of nose itching, dryness or irritation, runny nose, nausea, headache, dizziness, difficulty concentrating and unnatural fatigue. Conclusions: We found evidence...... that individual exposures to air pollution from biodegradable wastes are associated with increased occurrence of symptoms among residents. Stress-related mechanisms appear to underlie these effects....

  10. Gender Differences in Pulmonary Function, Respiratory Symptoms, and Macrophage Proteomics among HIV-Infected Smokers

    Directory of Open Access Journals (Sweden)

    Shiva D. Rahmanian

    2014-01-01

    Full Text Available Background. HIV-infected subjects have an increased incidence of pulmonary emphysema. There are known gender differences in COPD phenotypic expression and diagnosis, but this is not well characterized in lung disease related to HIV. We analyzed a group at risk for the development of COPD (HIV-infected smokers to determine gender differences in pulmonary symptoms, pulmonary function tests, and HRCT appearances. Methods. This was a cross-sectional, baseline analysis of a prospective study performed between 2006 and 2010. We performed symptomatic, pulmonary function, and computed tomography assessments in 243 HIV-infected smokers. In a subset bronchoalveolar lavage was performed with proteomic analysis of their alveolar macrophages. Results. The majority of the participants were male 213 (87.6%. There was significantly higher percentage of cough and phlegm production in males. There was also a lower FEV1 and a higher RV in males than females. Proteomic analysis revealed 29 proteins with at least a 2-fold higher expression in males and 13 identified proteins that were higher in females. Conclusions. In this group of HIV-infected smokers, airway symptoms and pulmonary function test abnormalities were higher in men than women. These gender differences may be due to differential expression of certain proteins in this group.

  11. Respirable coal dust exposure and respiratory symptoms in South-African coal miners: A comparison of current and ex-miners

    Energy Technology Data Exchange (ETDEWEB)

    Naidoo, R.N.; Robins, T.G.; Seixas, N.; Lalloo, U.G.; Becklake, M. [University of KwaZuluNatal, Congella (South Africa). Nelson R Mandela School of Medicine

    2006-06-15

    Dose-response associations between respirable dust exposure and respiratory symptoms and between symptoms and spirometry outcomes among currently employed and formerly employed South-African coal miners were investigated. Work histories, interviews, and spirometry and cumulative exposure were assessed among 684 current and 212 ex-miners. Results: Lower prevalences of symptoms were found among employed compared with ex-miners. Associations with increasing exposure for symptoms of phlegm and past history of tuberculosis were observed, whereas other symptom prevalences were higher in the higher exposure categories. Symptomatic ex-miners exhibited lower lung-function compared to the nonsymptomatic. Compared with published data, symptoms rates were low in current miners but high in ex-miners. Although explanations could include the low prevalence of smoking and/or reporting/selection bias, a 'Survivor' and/or a 'hire' effect is more likely, resulting in an underestimation of the dust-related effect.

  12. Prevalence of tuberculosis, HIV and respiratory symptoms in two Zambian communities: implications for tuberculosis control in the era of HIV.

    Directory of Open Access Journals (Sweden)

    Helen Ayles

    Full Text Available BACKGROUND: The Stop TB Partnership target for tuberculosis is to have reduced the prevalence of tuberculosis by 50% comparing 2015 to 1990. This target is challenging as few prevalence surveys have been conducted, especially in high burden tuberculosis and HIV countries. Current tuberculosis control strategies in high HIV prevalent settings are therefore based on limited epidemiological evidence and more evidence is needed from community-based surveys to inform improved policy formulation. METHODS AND FINDINGS: 8044 adults were sampled from 2 sub-districts (wards in Lusaka province, Zambia. Questionnaires were used to screen for symptoms, respiratory samples were obtained for culture and oral secretions collected for HIV testing. 79 individuals were found to have Mycobacterium tuberculosis in their sputum, giving an adjusted overall prevalence of tuberculosis of 870/100,000 (95% CI 570-1160/100,000. The adjusted overall prevalence of HIV was 28.61% (95% CI 26.04-31.19. HIV- infection was significantly associated with prevalent tuberculosis (Adj OR 2.3, 95% CI 1.42-3.74 and the population attributable fraction of HIV for prevalent tuberculosis was 36%. Symptoms such as prolonged cough (adj OR 12.72, 95% CI 7.05-22.94 and fever (Adj OR 2.04, 95%CI 1.23-3.39, were associated with prevalent tuberculosis, but 8 (10% individuals with prevalent tuberculosis denied having any symptoms at all and only 34 (43% would have been classified as a TB suspect by current guidelines. CONCLUSIONS: Undiagnosed tuberculosis is a challenge for tuberculosis control and new approaches are needed if we are to reach international targets. Epidemiological studies can inform screening algorithms for both detection and prevention of active tuberculosis.

  13. Focused sonography of the heart, lungs, and deep veins identifies missed life-threatening conditions in admitted patients with acute respiratory symptoms

    DEFF Research Database (Denmark)

    Laursen, Christian B; Sloth, Erik; Lambrechtsen, Jess;

    2013-01-01

    Patients with acute respiratory symptoms still remain a diagnostic challenge. The aim of the study was to evaluate whether focused sonography could potentially diagnose life-threatening conditions missed at the primary assessment in a patient population consisting of admitted patients with acute ...

  14. Effect of cannabis smoking on lung function and respiratory symptoms: a structured literature review

    Science.gov (United States)

    Ribeiro, Luis IG; Ind, Philip W

    2016-01-01

    As cannabis use increases, physicians need to be familiar with the effects of both cannabis and tobacco on the lungs. However, there have been very few long-term studies of cannabis smoking, mostly due to legality issues and the confounding effects of tobacco. It was previously thought that cannabis and tobacco had similar long-term effects as both cause chronic bronchitis. However, recent large studies have shown that, instead of reducing forced expiratory volume in 1 s and forced vital capacity (FVC), marijuana smoking is associated with increased FVC. The cause of this is unclear, but acute bronchodilator and anti-inflammatory effects of cannabis may be relevant. Bullous lung disease, barotrauma and cannabis smoking have been recognised in case reports and small series. More work is needed to address the effects of cannabis on lung function, imaging and histological changes. PMID:27763599

  15. Methodology of a randomized clinical trial of symptom management strategies in patients receiving chronic hemodialysis: the SMILE study.

    Science.gov (United States)

    Weisbord, Steven D; Shields, Anne Marie; Mor, Maria K; Sevick, Mary Ann; Homer, Marcia; Peternel, Janet; Porter, Patricia; Rollman, Bruce L; Palevsky, Paul M; Arnold, Robert M; Fine, Michael J

    2010-09-01

    Despite the high prevalence of pain, sexual dysfunction, and depression in patients on chronic hemodialysis, these symptoms are often unrecognized and under-treated by renal providers. This report describes the rationale and methodology of the SMILE study (Symptom Management Involving End-Stage Renal Disease), a multi-center, randomized clinical trial comparing the effectiveness of two strategies for implementing treatment for these symptoms in patients receiving chronic hemodialysis. Approximately 250 patients from nine outpatient dialysis units will participate. Over a 2-12 month observational phase, participants complete monthly surveys characterizing their pain, sexual dysfunction, and depression. Following this observational period, subjects are randomized to one of two study arms to receive a 12-month intervention. In one study arm (feedback intervention), patients continue to complete the same three symptom surveys, and the presence and severity of the symptoms reported on these surveys is mailed to the patient's renal provider along with evidence-based algorithms outlining treatment options for these symptoms. Decisions on treatment are left at the discretion of the provider. Patients randomized to the other study arm (management intervention) also continue to complete the same monthly symptom surveys and are evaluated by a symptom management nurse trained in the management of these symptoms. This nurse then discusses the patient's symptoms with the renal provider, provides specific recommendations for treatment, and facilitates the implementation of treatment. The primary endpoints are changes in scores on pain, erectile dysfunction, and depression surveys. This report describes the rationale and methodology of this clinical trial.

  16. Chronic pain in Noonan Syndrome: A previously unreported but common symptom.

    Science.gov (United States)

    Vegunta, Sravanthi; Cotugno, Richard; Williamson, Amber; Grebe, Theresa A

    2015-12-01

    Noonan syndrome (NS) is a multiple malformation syndrome characterized by pulmonic stenosis, cardiomyopathy, short stature, lymphatic dysplasia, craniofacial anomalies, cryptorchidism, clotting disorders, and learning disabilities. Eight genes in the RAS/MAPK signaling pathway are implicated in NS. Chronic pain is an uncommon feature. To investigate the prevalence of pain in NS, we distributed a two-part questionnaire about pain among NS individuals at the Third International Meeting on Genetic Syndromes of the Ras/MAPK Pathway. The first part of the questionnaire queried demographic information among all NS participants. The second part was completed by individuals with chronic pain. Questions included musculoskeletal problems and clinical features of pain. Forty-five questionnaires were analyzed; 53% of subjects were female. Mean age was 17 (2-48) years; 47% had a PTPN11 mutation. Sixty-two percent (28/45) of individuals with NS experienced chronic pain. There was a significant relationship between prevalence of pain and residing in a cold climate (P = 0.004). Pain occurred commonly in extremities/joints and head/trunk, but more commonly in extremities/joints (P = 0.066). Subjects with hypermobile joints were more likely to have pain (P = 0.052). Human growth hormone treatment was not statistically significant among subjects without chronic pain (P = 0.607). We conclude that pain is a frequent and under-recognized clinical feature of NS. Chronic pain may be associated with joint hypermobility and aggravated by colder climate. Our study is a preliminary investigation that should raise awareness about pain as a common symptom in children and adults with NS. PMID:26297936

  17. 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.

  18. Psychopathology and quality of life burden in chronic daily headache: influence of migraine symptoms.

    Science.gov (United States)

    Autret, A; Roux, S; Rimbaux-Lepage, S; Valade, D; Debiais, S

    2010-06-01

    The aim of this study is to compare the psychopathology and the quality of life of chronic daily headache patients between those with migraine headache and those with tension-type headache. We enrolled 106 adults with chronic daily headache (CDH) who consulted for the first time in specialised centres. The patients were classified according to the IHS 2004 criteria and the propositions of the Headache Classification Committee (2006) with a computed algorithm: 8 had chronic migraine (without medication overuse), 18 had chronic tension-type headache (without medication overuse), 80 had medication overuse headache and among them, 43 fulfilled the criteria for the sub-group of migraine (m) MOH, and 37 the subgroup for tension-type (tt) MOH. We tested five variables: MADRS global score, HAMA psychic and somatic sub-scales, SF-36 psychic, and somatic summary components. We compared patients with migraine symptoms (CM and mMOH) to those with tension-type symptoms (CTTH and ttMOH) and neutralised pain intensity with an ANCOVA which is a priori higher in the migraine group. We failed to find any difference between migraine and tension-type groups in the MADRS global score, the HAMA psychological sub-score and the SF36 physical component summary. The HAMA somatic anxiety subscale was higher in the migraine group than in the tension-type group (F(1,103) = 10.10, p = 0.001). The SF36 mental component summary was significantly worse in the migraine as compared with the tension-type subgroup (F(1,103) = 5.758, p = 0.018). In the four CDH subgroups, all the SF36 dimension scores except one (Physical Functioning) showed a more than 20 point difference from those seen in the adjusted historical controls. Furthermore, two sub-scores were significantly more affected in the migraine group as compared to the tension-type group, the physical health bodily pain (F(1,103) = 4.51, p = 0.036) and the mental health (F(1,103) = 8.17, p = 0.005). Considering that the statistic procedure

  19. Complex interaction of sensory and motor signs and symptoms in chronic CRPS.

    Directory of Open Access Journals (Sweden)

    Volker Huge

    Full Text Available Spontaneous pain, hyperalgesia as well as sensory abnormalities, autonomic, trophic, and motor disturbances are key features of Complex Regional Pain Syndrome (CRPS. This study was conceived to comprehensively characterize the interaction of these symptoms in 118 patients with chronic upper limb CRPS (duration of disease: 43±23 months. Disease-related stress, depression, and the degree of accompanying motor disability were likewise assessed. Stress and depression were measured by Posttraumatic Stress Symptoms Score and Center for Epidemiological Studies Depression Test. Motor disability of the affected hand was determined by Sequential Occupational Dexterity Assessment and Michigan Hand Questionnaire. Sensory changes were assessed by Quantitative Sensory Testing according to the standards of the German Research Network on Neuropathic Pain. Almost two-thirds of all patients exhibited spontaneous pain at rest. Hand force as well as hand motor function were found to be substantially impaired. Results of Quantitative Sensory Testing revealed a distinct pattern of generalized bilateral sensory loss and hyperalgesia, most prominently to blunt pressure. Patients reported substantial motor complaints confirmed by the objective motor disability testings. Interestingly, patients displayed clinically relevant levels of stress and depression. We conclude that chronic CRPS is characterized by a combination of ongoing pain, pain-related disability, stress and depression, potentially triggered by peripheral nerve/tissue damage and ensuing sensory loss. In order to consolidate the different dimensions of disturbances in chronic CRPS, we developed a model based on interaction analysis suggesting a complex hierarchical interaction of peripheral (injury/sensory loss and central factors (pain/disability/stress/depression predicting motor dysfunction and hyperalgesia.

  20. Platelet hyperactivity, neurobehavioral symptoms and depression among Indian women chronically exposed to low level of arsenic.

    Science.gov (United States)

    Mukherjee, Bidisha; Bindhani, Banani; Saha, Hirak; Sinha, Dona; Ray, Manas Ranjan

    2014-12-01

    The prevalence of neurobehavioral symptoms (NBS) and depression has been investigated in premenopausal rural women of West Bengal, India enrolled from arsenic (As) endemic (groundwater As 11-50 μg/L; n = 342) and control areas (As level ≤ 10 μg/L; n = 312). The subjective symptoms questionnaire and Beck's 21-point depression inventory-II were used for the detection of NBS and depression, respectively. Platelet P-selectin expression was measured by flow cytometry, plasma neurotransmitter activity with high performance liquid chromatography and groundwater As level by atomic absorption spectroscopy. The As level in groundwater was 2.72 ± 1.18 μg/L in control and 28.3 ± 13.51 μg/L in endemic areas (p memory (69.9 vs. 28.2%, p dopamine level was not significantly different (p>0.05) from that of controls. Moreover, women from endemic areas had 2.3-times more P-selectin-expressing platelets in their circulation (p < 0.001). After controlling the potential confounders, chronic low level As (11-50 μg/L) exposure showed a positive association with the prevalence of neurobehavioral symptoms and depression among Indian women in their child-bearing age. PMID:25451969

  1. Acute effects of winter air pollution on respiratory health

    NARCIS (Netherlands)

    Zee, van der S.

    1999-01-01

    In this thesis, acute respiratory health effects of exposure to winter air pollution are investigated in panels of children (7-11 yr) and adults (50-70 yr) with and without chronic respiratory symptoms, living in urban and non-urban areas in the Netherlands. The study was performed during three cons

  2. Association of Sand Dust Particles with Pulmonary Function and Respiratory Symptoms in Adult Patients with Asthma in Western Japan Using Light Detection and Ranging: A Panel Study

    Science.gov (United States)

    Watanabe, Masanari; Noma, Hisashi; Kurai, Jun; Shimizu, Atsushi; Sano, Hiroyuki; Kato, Kazuhiro; Mikami, Masaaki; Ueda, Yasuto; Tatsukawa, Toshiyuki; Ohga, Hideki; Yamasaki, Akira; Igishi, Tadashi; Kitano, Hiroya; Shimizu, Eiji

    2015-01-01

    Light detection and ranging (LIDAR) can estimate daily volumes of sand dust particles from the East Asian desert to Japan. The objective of this study was to investigate the relationship between sand dust particles and pulmonary function, and respiratory symptoms in adult patients with asthma. One hundred thirty-seven patients were included in the study. From March 2013 to May 2013, the patients measured their morning peak expiratory flow (PEF) and kept daily lower respiratory symptom diaries. A linear mixed model was used to estimate the correlation of the median daily levels of sand dust particles, symptoms scores, and PEF. A heavy sand dust day was defined as an hourly concentration of sand dust particles of >0.1 km−1. By this criterion, there were 8 heavy sand dust days during the study period. Elevated sand dust particles levels were significantly associated with the symptom score (0.04; 95% confidence interval (CI); 0.03, 0.05), and this increase persisted for 5 days. There was no significant association between PEF and heavy dust exposure (0.01 L/min; 95% CI, −0.62, 0.11). The present study found that sand dust particles were significantly associated with worsened lower respiratory tract symptoms in adult patients with asthma, but not with pulmonary function. PMID:26501307

  3. 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.

  4. 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

  5. Respiratory function in female workers occupationally exposed to organic dusts in food processing industries.

    Science.gov (United States)

    Zuskin, E; Mustajbegović, J; Schachter, E N; Kern, J; Ivanković, D; Heimer, S

    2000-01-01

    Respiratory consequences of work in food processing industry were studied in 764 female workers exposed to organic dusts associated with the processing of green and roasted coffee, tea, spices, dried fruits, cocoa and flour. A group of 387 female workers not exposed to respiratory irritants served as controls for the prevalence of acute (during work shift) and chronic respiratory symptoms. A greater prevalence of all acute and chronic respiratory symptoms was consistently found among exposed workers than among control workers. The highest prevalence of chronic respiratory symptoms was recorded for chronic cough (40%), followed by acute symptoms of dry cough (58.7%). The difference in the prevalence of chronic respiratory symptoms between the exposed and control workers was in general significant (p DSCG) significantly diminished across-shift reductions for FEF50 and FEF25 in a subgroup of the examined workers. Our data suggested the female workers employed in food processing industry to be at risk of developing both acute and chronic respiratory symptoms as well as ventilatory capacity impairment as the result of occupational exposures. PMID:11379483

  6. 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.

  7. The possibility of evaluation on inflammatory change at respiratory tract in chronic bronchial asthma using 67Ga scintigraphy

    International Nuclear Information System (INIS)

    67Ga scintigraphy was performed in 17 patients with chronic bronchial asthma to grasp the inflammatory change of respiratory tract. On 67Ga scintigraphy, abnormal accumulations were detected on lung fields in 6 cases (35.3%) of 17 cases. In 5 cases of these 6 cases, the defect areas which were pointed out on 81mKr ventilation scintigraphy were matched to the abnormal accumulation areas which were pointed out on 67Ga scintigraphy. In dynamics, the abnormal accumulation areas which were pointed out on 67Ga scintigraphy were matched to the defect areas which had been at all times pointed out on 81mKr ventilation scintigraphy. 67Ga scintigraphy was expected to be one of index to grasp the inflammatory change of respiratory tract in patients with chronic bronchial asthma. (author)

  8. 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.

  9. 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...

  10. 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...

  11. 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...

  12. Occupational exposure to pesticides and respiratory health

    Directory of Open Access Journals (Sweden)

    Ali Mamane

    2015-06-01

    Full Text Available This article aims to review the available literature regarding the link between occupational exposure to pesticides and respiratory symptoms or diseases. Identification of epidemiological studies was performed using PubMed. 41 articles were included, 36 regarding agricultural workers and five regarding industry workers. Among the 15 cross-sectional studies focusing on respiratory symptoms and agricultural pesticide exposure, 12 found significant associations with chronic cough, wheeze, dyspnoea, breathlessness or chest tightness. All four studies on asthma found a relationship with occupational exposure, as did all three studies on chronic bronchitis. The four studies that performed spirometry reported impaired respiratory function linked to pesticide exposure, suggestive of either obstructive or restrictive syndrome according to the chemical class of pesticide. 12 papers reported results from cohort studies. Three out of nine found a significant relationship with increased risk of wheeze, five out of nine with asthma and three out of three with chronic bronchitis. In workers employed in pesticide production, elevated risks of chronic obstructive pulmonary disease (two studies out of three and impaired respiratory function suggestive of an obstructive syndrome (two studies out of two were reported. In conclusion, this article suggests that occupational exposure to pesticides is associated with an increased risk of respiratory symptoms, asthma and chronic bronchitis, but the causal relationship is still under debate.

  13. 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. 

  14. [Symptoms of atopy in persons exposed to chronic immunosuppression of polycyclic aromatic hydrocarbons].

    Science.gov (United States)

    Szczeklik, J; Kowalczyk, E; Gałuszka, Z

    1995-01-01

    The frequency of the atopy symptoms was estimated in 126 coke oven workers chronically exposed to polycyclic aromatic hydrocarbons (PAHs). The assessment was based on questionnaire, point skin tests with the allergens of dust, feathers, mould grass as well as on the measurements of total blood serum IgE concentration. The control group was consisted of 75 men, workers of cold rolling mill division where the environmental conditions were much better. It was observed that positive questionnaire data and positive skin tests were significantly less frequent in men exposed to PAHs. The men serum IgE values were not statistically different in both group workers although in coke oven workers the tendency to higher IgE values was observed. It is rather suggested that more useful method might be the measurement of specific serum IgE.

  15. 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...

  16. Diagnostic accuracy of an integrated respiratory guideline in identifying patients with respiratory symptoms requiring screening for pulmonary tuberculosis: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Majara Bosielo P

    2006-08-01

    Full Text Available Abstract Background To evaluate the diagnostic accuracy of the integrated Practical Approach to Lung Health in South Africa (PALSA guideline in identifying patients requiring bacteriological screening for tuberculosis (TB, and to determine which clinical features best predict suspected and bacteriologically-confirmed tuberculosis among patients with respiratory symptoms. Methods A prospective, cross-sectional study in which 1392 adult patients with cough and/or difficult breathing, attending a primary care facility in Cape Town, South Africa, were evaluated by a nurse using the guideline. The accuracy of a nurse using the guideline to identify TB suspects was compared to that of primary care physicians' diagnoses of (1 suspected TB, and (2 proven TB supported by clinical information and chest radiographs. Results The nurse using the guideline identified 516 patients as TB suspects compared with 365 by the primary care physicians, representing a sensitivity of 76% (95% confidence interval (CI 71%–79%, specificity of 77% (95% CI 74%–79%, positive predictive value of 53% (95% CI 49%–58%, negative predictive value of 90% (95% CI 88%–92%, and area under the receiver operating characteristic curve (ARUC of 0.76 (95% CI 0.74–0.79. Sputum results were obtained in 320 of the 365 primary care physicians TB suspects (88%; 40 (13% of these were positive for TB. Only 4 cases were not identified by the nurse using the guideline. The primary care physicians diagnostic accuracy in diagnosing bacteriologically-confirmed TB (n = 320 was as follows: sensitivity 90% (95% CI 76%–97%, specificity 65% (95% CI 63%–68%, negative predictive value 7% (95% CI 5%–10%, positive predictive value 99.5% (95% CI 98.8%–99.8%, and ARUC 0.78 (95% CI 0.73–0.82. Weight loss, pleuritic pain, and night sweats were independently associated with the diagnosis of bacteriologically-confirmed tuberculosis (positive likelihood ratio if all three present = 16.7, 95% CI 5

  17. Improvement of symptoms of non-allergic chronic rhinitis by local treatment with capsaicin.

    Science.gov (United States)

    Lacroix, J S; Buvelot, J M; Polla, B S; Lundberg, J M

    1991-09-01

    Sixteen adult patients suffering from severe chronic non-allergic rhinitis with nasal vasoconstrictor abuse for more than a year, received, under local anaesthesia, an intranasal spray of capsaicin (3.3 x 10(-3) mol), the pungent agent in hot pepper, once weekly for 5 weeks. The subjective intensity of their nasal obstruction, rhinorrhoea and sneezing frequency were evaluated throughout the study and the vascular effects of capsaicin on the nasal mucosa were recorded by anterior rhinomanometry and laser Doppler flowmetry. Calcitonin gene-related peptide (CGRP) is a vasodilator agent present in sensory nerves and may play a major role in the vascular component of neurogenic inflammation. Therefore, the nasal mucosa content of CGRP-like immunoreactivity (CGRP-LI) was determined by radioimmunoassay in biopsies obtained before and after the capsaicin treatment. Intra-nasal capsaicin application evoked a larger vascular response in patients with rhinitis than in controls (P less than 0.05). Both nasal vascular responses and subjective discomfort following capsaicin were markedly reduced after the fifth application (P less than 0.01). In parallel, a 50% reduction of the CGRP-LI content in the nasal biopsies was observed. All symptoms were significantly improved throughout a 6 month follow-up period. No significant side-effects occurred and weaning from nasal vasoconstrictor agents was possible. Both the subjective symptom score and objective measurements of vascular reactivity suggest that repeated intra-nasal capsaicin application could be beneficial for patients with chronic rhinitis, possibly by reducing hyperreactive nasal reflexes. PMID:1742652

  18. Caught in the thickness of brain fog: exploring the cognitive symptoms of Chronic Fatigue Syndrome

    Directory of Open Access Journals (Sweden)

    Anthony James Ocon

    2013-04-01

    Full Text Available Chronic Fatigue Syndrome (CFS is defined as greater than 6 months of persistent fatigue that is experienced physically and cognitively. The cognitive symptoms are generally thought to be a mild cognitive impairment, but individuals with CFS subjectively describe them as brain fog. The impairment is not fully understood and often is described as slow thinking, difficulty focusing, confusion, lack of concentration, forgetfulness, or a haziness in thought processes. Causes of brain fog and mild cognitive impairment have been investigated. Possible physiological correlates may be due to the effects of chronic orthostatic intolerance in the form of the Postural Tachycardia Syndrome and decreases in cerebral blood flow. In addition, fMRI studies suggest that individuals with CFS may require increased cortical and subcortical brain activation to complete difficult mental tasks. Furthermore, neurocognitive testing in CFS has demonstrated deficits in speed and efficiency of information processing, attention, concentration, and working memory. The cognitive impairments are then perceived as an exaggerated mental fatigue. As a whole, this is experienced by those with CFS as brain fog and may be viewed as the interaction of physiological, cognitive, and perceptual factors. Thus, the cognitive symptoms of CFS may be due to altered cerebral blood flow activation and regulation that are exacerbated by a stressor, such as orthostasis or a difficult mental task, resulting in the decreased ability to readily process information, which is then perceived as fatiguing and experienced as brain fog. Future research looks to further explore these interactions, how they produce cognitive impairments, and explain the perception of brain fog from a mechanistic standpoint.

  19. Prevalence of chronic ankle instability and associated symptoms in university dance majors: an exploratory study.

    Science.gov (United States)

    Simon, Janet; Hall, Emily; Docherty, Carrie

    2014-01-01

    Previous investigations have established that dancers suffer a large number of injuries to the lower leg, foot, and ankle, with a portion of these being significant time loss injuries or in some cases career ending. Lateral ankle sprain is a common injury in dancers and can often lead to recurrent instability and repetitive injuries. Research in other active populations has linked ankle sprains to the development of chronic ankle instability (CAI). Therefore, the purpose of this study was to identify the prevalence of CAI and related symptoms of ankle sprain in a student dance population. Individuals were included if they were currently a modern or ballet dance major at the investigators' university (exclusion criterion: a history of fracture or surgery in the lower extremities). A self-reported demographic questionnaire and the Identification of Functional Ankle Instability survey were used to identify the presence and characteristics of CAI. A total of 83 questionnaires were collected, and after exclusions, 77 participants remained: 43 modern dancers and 34 ballet dancers (10 males and 67 females, mean age 19.61 ± 2.53 years, mean dance experience 13.61 ± 3.16 years). Of all dancers surveyed, 41 (53.2%) had CAI, and of those 24 (58.5%) were modern dancers, and 17 (41.5%) were ballet dancers. When looking only at those dancers who had a previous lateral ankle sprain, 75.9% were identified as having CAI. Chronic Ankle Instability can create long-term problems for anyone but especially female dancers, who place extreme stress on their feet and ankles from being en pointe or demi-pointe. It is important to educate dancers, instructors, and medical staff of the importance of recognizing CAI and seeking medical care for ankle sprains and their residual symptoms. PMID:25474297

  20. Clinical and Laboratory Findings in Patients With Acute Respiratory Symptoms That Suggest the Necessity of Chest X-ray for Community-Acquired Pneumonia

    International Nuclear Information System (INIS)

    Pneumonia is a common illness in all parts of the world and is considered as a major cause of death among all age groups. Nevertheless, only about 5% of patients referring to their primary care physicians with acute respiratory symptoms will develop pneumonia. This study was performed to derive practical criteria for performing chest radiographs for the evaluation of community-acquired pneumonia (CAP). A total of 420 patients with acute respiratory symptoms and positive findings on chest radiograph were evaluated from December 2008 to December 2009. The subjects were referred to outpatient clinics or emergency departments of Birjand's medical university hospitals, Iran, and were enrolled as positive cases. A checklist was completed for each patient including their demographic information, clinical signs and symptoms (cough, sputum production, dyspnea, chest pain, fever, tachycardia, and tachypnea), abnormal findings in pulmonary auscultation and laboratory findings (erythrocyte sedimentation rate, C-reactive protein levels, and white blood cell count). An equal number of age-matched individuals with acute respiratory symptoms, but insignificant findings on chest radiography, were included as the control group. Finally, the diagnostic values of different findings were compared. The data showed that vital signs and physical examination findings are useful screening parameters for predicting chest radiograph findings in outpatient settings. Therefore, by implementing a prediction rule, we would be able to determine which patients would benefit from a chest X-Ray (sensitivity, 94% and specificity, 57%). This study's findings suggest that requesting chest radiographs might not be necessary in patients with acute respiratory symptoms unless the vital signs and/or physical examination findings are abnormal. Considering the 94% sensitivity of this rule for predicting CAP, a chest radiograph is required for patients with unreliable follow-ups or moderate to high

  1. 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).

  2. Mental strain and chronic stress among a communit sample of university students with irritable bowel syndrome symptoms

    OpenAIRE

    Gulewitsch, Marco D.; Paul Enck; Juliane Schwille-Kiuntke; Katja Weimer; Schlarb, Angelika A.

    2013-01-01

    Aim. To investigate the degree of mental strain and chronic stress in a German community sample of students with IBS-like symptoms. Methods and Materials. Following an internet-based survey about stress, this study recruited 176 German university students (23.45 ± 2.48 years; 48.3% males) with IBS-like symptoms according to Rome III and 181 students without IBS (23.55 ± 2.82 years; 50.3% males) and compared them regarding current mental strain (SCL-90-R) and the extend of chronic stress. Beyo...

  3. Different gastoroesophageal reflux symptoms of middle-aged to elderly asthma and chronic obstructive pulmonary disease (COPD) patients

    OpenAIRE

    Shimizu, Yasuo; Dobashi, Kunio; Kusano, Motoyasu; Mori, Masatomo

    2011-01-01

    Symptomatic differences and the impact of gastroesophageal reflux disease (GERD) have not been clarified in patients with asthma and chronic obstructive pulmonary disease (COPD). The purpose of this study is to assess the differences of GERD symptoms among asthma, COPD, and disease control patients, and determine the impact of GERD symptoms on exacerbation of asthma or COPD by using a new questionnaire for GERD. A total of 120 subjects underwent assessment with the frequency scale for the sym...

  4. A randomized, double-blind, placebo-controlled pilot study of a probiotic in emotional symptoms of chronic fatigue syndrome

    OpenAIRE

    Rao A Venket; Bested Alison C; Beaulne Tracey M; Katzman Martin A; Iorio Christina; Berardi John M; Logan Alan C

    2009-01-01

    Abstract Chronic fatigue syndrome (CFS) is complex illness of unknown etiology. Among the broad range of symptoms, many patients report disturbances in the emotional realm, the most frequent of which is anxiety. Research shows that patients with CFS and other so-called functional somatic disorders have alterations in the intestinal microbial flora. Emerging studies have suggested that pathogenic and non-pathogenic gut bacteria might influence mood-related symptoms and even behavior in animals...

  5. Depressive symptoms in people with chronic physical conditions: prevalence and risk factors in a Hong Kong community sample

    Directory of Open Access Journals (Sweden)

    Nan Hairong

    2012-11-01

    Full Text Available Abstract Background Depression is predicted to become one of the two most burdensome diseases worldwide by 2020 and is common in people with chronic physical conditions. However, depression is relatively uncommon in Asia. Family support is an important Asian cultural value that we hypothesized could protect people with chronic physical conditions from developing depression. We investigated depressive symptom prevalence and risk factors in a Chinese sample with chronic medical conditions, focusing on the possible protective role of family relationships. Methods Data were obtained from the Hong Kong Jockey Club FAMILY Project cohort study in 2009–2011, which included 6,195 participants (age ≥15 with self-reported chronic conditions. Depressive symptoms were recorded using the Patient Health Questionnaire-9 (PHQ-9. Demographic and lifestyle variables, stressful life events, perceived family support and neighborhood cohesion were assessed. Factors associated with a non-somatic (PHQ-6 depression score were also examined. Results The prevalence of depressive symptoms (PHQ-9 scores ≥5 was 17% in those with one or more chronic conditions, and was more prevalent in women than in men (19.7% vs. 13.9%; p p p  Conclusions Acute life stress and the number of chronic conditions, together with socio-demographic factors, explain most variance in depressive symptoms among chronically ill Chinese individuals. Somatic items in the PHQ-9 increased the depression scores but they did not alter the pattern of predictors. Family support appears to be an important protective factor in Chinese cultures for individuals with chronic conditions.

  6. Incidence of gastroesophageal reflux symptoms in patients with refractory chronic sinusitis upon clinical treatment

    Directory of Open Access Journals (Sweden)

    Oliveira, Marcela Schmidt B. de

    2009-09-01

    Full Text Available Introduction: The chronic rhinosinusitis (CRS is a pathology that has structural and histological alterations. The association between CRS and the gastroesophageal reflux disease (GERD has been widely discussed in the last years. For this relationship to be confirmed, it is necessary to find evidences that the patients with CRS present a major incidence of GERD, that the physiopathology of both diseases explains the association between them and that the GERD treatment cures or improves the CRS' symptoms. Objectives: To evaluate the incidence of GERD in patients with CRS and a level of improvement of the nasosinusal disease symptoms after treatment with protons pump inhibitors. Methods: Retrospective study with 30 patients with CRS refractory to the clinical treatment and/or nasal cavity polypoid pathology with indication of the paranasal sinuses functional endoscopic surgery. We applied a questionnaire for evaluation of the symptomatology and previous treatment for gastroesophageal reflux. The data were submitted to statistical analysis by the Chi-Square test or Fisher's exact test with a significance of 5%. Results: Out of the patients with GERD, 33% had an improvement of the CRS' symptomatology with medications for treatment of the gastric pathology. Conclusion: It is not possible yet to state that the GER is a factor responsible for the CRS and it must be researched as a cofactor or eliciting factor when there is not other evident etiology. However, there are plausible biological mechanisms for such association.

  7. Chronic whiplash symptoms are related to altered regional cerebral blood flow in the resting state.

    Science.gov (United States)

    Linnman, Clas; Appel, Lieuwe; Söderlund, Anne; Frans, Orjan; Engler, Henry; Furmark, Tomas; Gordh, Torsten; Långström, Bengt; Fredrikson, Mats

    2009-01-01

    The neural pathogenic mechanisms involved in mediating chronic pain and whiplash associated disorders (WAD) after rear impact car collisions are largely unknown. This study's first objective was to compare resting state regional cerebral blood flow (rCBF) by means of positron emission tomography with (15)O labelled water in 21 WAD patients with 18 healthy, pain-free controls. A second objective was to investigate the relations between brain areas with altered rCBF to pain experience, somatic symptoms, posttraumatic stress symptoms and personality traits in the patient group. Patients had heightened resting rCBF bilaterally in the posterior parahippocampal and the posterior cingulate gyri, in the right thalamus and the right medial prefrontal gyrus as well as lowered tempero-occipital blood flow compared with healthy controls. The altered rCBF in the patient group was correlated to neck disability ratings. We thus suggest an involvement of the posterior cingulate, parahippocampal and medial prefrontal gyri in WAD and speculate that alterations in the resting state are linked to an increased self-relevant evaluation of pain and stress. PMID:18486506

  8. Possibilities of balneotherapy in treatment of subjective symptoms of chronic low back pain (lumbar syndrome

    Directory of Open Access Journals (Sweden)

    Batsialou Ioanna

    2002-01-01

    Full Text Available Introduction Chronic low back pain is a degenerative rheumatic disease and is characterized by various symptoms and clinical signs. Balneotherapy Balneotherapy represents a therapy by various hot or warm baths in natural mineral waters of specific physical and chemical characteristics. When used externally, they have mechanical, chemical and thermic effects. Balneotherapy of lumbar syndrome includes: individual baths, swimming in the pool, hydrokinesitherapy, underwater massage, underwater extension, mud therapy, mud baths. The therapy should be closely monitored for optimal efficacy and it is necessary to examine: functional status of the lumbosacral region, general functional status (level of activity, lower extremities, pain measurement, use of non-steroid anti-rheumatic and analgesic agents. In order to follow-up the effects of therapy and establish the prognosis it is important to perform: detailed anamnesis, anthropometrics measurements, socio-epidemiological research, clinical examinations. Conclusion Lumbar syndrome is usually caused by a degenerative disease of the spinal column. More than 25% of people under 45 years of age are unable to work due to chronic low back pain. That is why preventive measures, prompt diagnosis and adequate therapy are of utmost importance.

  9. 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

  10. Energy expenditure at rest and during walking in patients with chronic respiratory failure: a prospective two-phase case-control study.

    Directory of Open Access Journals (Sweden)

    Ernesto Crisafulli

    Full Text Available BACKGROUND: Measurements of Energy Expenditure (EE at rest (REE and during physical activities are increasing in interest in chronic patients. In this study we aimed at evaluating the validity/reliability of the SenseWear®Armband (SWA device in terms of REE and EE during assisted walking in Chronic Respiratory Failure (CRF patients receiving long-term oxygen therapy (LTOT. METHODOLOGY/PRINCIPAL FINDINGS: In a two-phase prospective protocol we studied 40 severe patients and 35 age-matched healthy controls. In phase-1 we determined the validity and repeatability of REE measured by SWA (REEa in comparison with standard calorimetry (REEc. In phase-2 we then assessed EE and Metabolic Equivalents-METs by SWA during the 6-minute walking test while breathing oxygen in both assisted (Aid or unassisted (No-Aid modalities. When compared with REEc, REEa was slightly lower in patients (1351±169 vs 1413±194 kcal/day respectively, p<0.05, and less repeatable than in healthy controls (0.14 and 0.43 coefficient respectively. COPD patients with CRF patients reported a significant gain with Aid as compared with No-Aid modality in terms of meters walked, perceived symptoms and EE. CONCLUSIONS/SIGNIFICANCE: SWA provides a feasible and valid method to assess the energy expenditure in CRF patients on LTOT, and it shows that aided walking results in a substantial energy saving in this population.

  11. Influence of patient symptoms and physical findings on general practitioners' treatment of respiratory tract infections: a direct observation study

    Directory of Open Access Journals (Sweden)

    Kochen Michael M

    2005-02-01

    Full Text Available Abstract Background The high rate of antibiotic prescriptions general practitioners (GPs make for respiratory tract infections (RTI are often explained by non-medical reasons e.g. an effort to meet patient expectations. Additionally, it is known that GPs to some extent believe in the necessity of antibiotic treatment in patients with assumed bacterial infections and therefore attempt to distinguish between viral and bacterial infections by history taking and physical examination. The influence of patient complaints and physical examination findings on GPs' prescribing behaviour was mostly investigated by indirect methods such as questionnaires. Methods Direct, structured observation during a winter "cough an cold period" in 30 (single handed general practices. All 273 patients with symptoms of RTI (age above 14, median 37 years, 51% female were included. Results The most frequent diagnoses were 'uncomplicated upper RTI/common cold' (43% followed by 'bronchitis' (26%. On average, 1.8 (95%-confidence interval (CI: 1.7–2.0 medicines per patient were prescribed (cough-and-cold preparations in 88% of the patients, antibiotics in 49%. Medical predictors of antibiotic prescribing were pathological findings in physical examination such as coated tonsils (odds ratio (OR 15.4, 95%-CI: 3.6–66.2 and unspecific symptoms like fatigue (OR 3.1, 95%-CI 1.4–6.7, fever (OR 2.2, 95%-CI: 1.1–4.5 and yellow sputum (OR 2.1, 95%-CI: 1.1–4.1. Analysed predictors explained 70% of the variance of antibiotic prescribing (R2 = 0,696. Efforts to reduce antibiotic prescribing, e.g. recommendations for self-medication, counselling on home remedies or delayed antibiotic prescribing were rare. Conclusions Patient complaints and pathological results in physical examination were strong predictors of antibiotic prescribing. Efforts to reduce antibiotic prescribing should account for GPs' beliefs in those (non evidence based predictors. The method of direct observation was

  12. The morphological changes of the aeroheamatic barrier of the respiratory portion of lungs at chronic hepatic insufficiency.

    Directory of Open Access Journals (Sweden)

    Alekseenko A.A.

    2007-01-01

    Full Text Available The purpose of the work was to determine the consequence of pathomorphological changes of the respiratory part and surfactant system of lungs at hepatic insufficiency, and also to estimate the dynamics of changes of both compensate and decompensate types in experimental model. 88 mature rats both sexes for modeling of the hepatic insufficiency by the Саmегоn’s method were used. Rat lungs were examined in 2, 4, 8 and 16 weeks after beginning of experiment. The increase of the volume of regions with emphysema, dysthelectasis and athelectasis at in the respiratory portion of the lungs were found. The increase of interstitial components with decreasing of relative thickness of epithelial layer of alveoli and the endothelial cells in capillaries were observed in aero-hematic barrier. The increase of vessel permeability, formation of hemorrhages, dysthelectasis and athelectasis are observed in the respiratory portion at chronic hepatic insufficiency. The sclerotic changes in the interalveolar septa with pneumofibrosis are determined in the terminal stages of chronic endotoxicosis.

  13. Profile of cognitive deficits and associations with depressive symptoms and intelligence in chronic early-onset schizophrenia patients

    DEFF Research Database (Denmark)

    Jepsen, Jens Richardt Møllegaard; Fagerlund, Birgitte; Pagsberg, Anne Katrine;

    2013-01-01

    Cognitive deficits in several domains have been demonstrated in early-onset schizophrenia patients but their profile and relation to depressive symptoms and intelligence need further characterization. The purpose was to characterize the profile of cognitive deficits in chronic, early-onset schizo......Cognitive deficits in several domains have been demonstrated in early-onset schizophrenia patients but their profile and relation to depressive symptoms and intelligence need further characterization. The purpose was to characterize the profile of cognitive deficits in chronic, early......-onset schizophrenia patients, assess the potential associations with depressive symptom severity, and examine whether cognitive deficits within several domains reflect intelligence impairments. This study compared attention, visual-construction, aspects of visual and verbal memory, and executive functions in chronic......, and executive functions were accounted for by deficits in intelligence, while this was not the case for deficits of verbal recall of stories or attention. No significant associations were observed between the severity of cognitive deficits and that of depressive symptoms. Chronic, early-onset schizophrenia...

  14. 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.

  15. Risk of chronic bronchitis in twin pairs discordant for smoking

    DEFF Research Database (Denmark)

    Meteran, Howraman; Thomsen, Simon Francis; Harmsen, Lotte;

    2012-01-01

    It is well known that smoking is a major risk factor for lung disease and respiratory symptoms. We examined the association between smoking and the risk of chronic bronchitis in a large twin sample....

  16. Respiratory sinus arrhythmia as a predictor of eating disorder symptoms in college students: Moderation by responses to stress and parent psychological control.

    Science.gov (United States)

    Abaied, Jamie L; Wagner, Caitlin; Breslend, Nicole Lafko; Flynn, Megan

    2016-04-01

    This longitudinal study examined the prospective contribution of respiratory sinus arrhythmia (RSA), a key physiological indicator of self-regulation, to eating disorder symptoms in college students, and whether this link was moderated by maladaptive responses to stress and parent psychological control. At Wave 1, college students' RSA was measured at rest. At Waves 1 and 2 (six-month follow-up), students reported on their eating disorder symptoms, coping and involuntary responses to stress, and perceptions of their parents' use of psychological control. Significant three-way interactions indicated that the link between RSA and subsequent eating disorder symptoms was contingent on responses to stress and parent psychological control. In the context of maladaptive responses to stress and high psychological control, RSA predicted increased eating disorder symptoms over time. In the absence of parent psychological control, high RSA was beneficial in most cases, even when individuals reported maladaptive responses to stress. This study presents novel evidence that high RSA contributes to risk for or resilience to eating disorder symptoms over time. RSA can be protective against eating disorder symptoms, but in some contexts, the self-regulation resources that high RSA provides may be inappropriately applied to eating cognitions and behaviors. This research highlights the importance of examining physiological functioning conjointly with other risk factors as precursors to eating disorder symptoms over time.

  17. Respiratory sinus arrhythmia as a predictor of eating disordspan>er symptoms in college students: Moderation by responses to stress and parent psychological control.

    Science.gov (United States)

    Abaied, Jamie L; Wagner, Caitlin; Breslend, Nicole Lafko; Flynn, Megan

    2016-04-01

    This longitudinal study examined the prospective contribution of respiratory sinus arrhythmia (RSA), a key physiological indicator of self-regulation, to eating disorder symptoms in college students, and whether this link was moderated by maladaptive responses to stress and parent psychological control. At Wave 1, college students' RSA was measured at rest. At Waves 1 and 2 (six-month follow-up), students reported on their eating disorder symptoms, coping and involuntary responses to stress, and perceptions of their parents' use of psychological control. Significant three-way interactions indicated that the link between RSA and subsequent eating disorder symptoms was contingent on responses to stress and parent psychological control. In the context of maladaptive responses to stress and high psychological control, RSA predicted increased eating disorder symptoms over time. In the absence of parent psychological control, high RSA was beneficial in most cases, even when individuals reported maladaptive responses to stress. This study presents novel evidence that high RSA contributes to risk for or resilience to eating disorder symptoms over time. RSA can be protective against eating disorder symptoms, but in some contexts, the self-regulation resources that high RSA provides may be inappropriately applied to eating cognitions and behaviors. This research highlights the importance of examining physiological functioning conjointly with other risk factors as precursors to eating disorder symptoms over time. PMID:26826976

  18. Comparison of symptom and risk assessment methods among patients with chronic obstructive pulmonary disease

    Institute of Scientific and Technical Information of China (English)

    Zhang Rongbao; Tan Xingyu; He Quanying; Chen Qing; Gai Jun; Wei Jing'an; Wang Yan

    2014-01-01

    Background The global strategy for the diagnosis,management and prevention of chronic obstructive pulmonary disease (COPD) guidelines classify patients into four groups according to the number of symptoms and the level of future risk of acute exacerbation COPD (AECOPD).This study aimed to compare the results of different methods used in diagnosis of COPD and evaluate the accuracy of the assessment methods in guiding clinical practice.Methods A survey was conducted of 194 COPD outpatients between March and September 2012.Demographic characteristics,the number of exacerbations the patient has had within the previous 12 months,COPD assessment test (CAT),Modified British Medical Research Council (mMRC) scale,and results of the lung function tests were recorded.Results Of the 194 patients assessed,21 had a CAT score ≥10 and an mMRC grade ≤1,13 had a CAT score <10 and an mMRC grade ≥2.A predicted forced expiratory volume in one second (FEV1%) of <50% with less than two acute exacerbations was observed in 39 patients,while a predicted FEV1% of ≥50% was noted in 20 patients with two or more acute exacerbations.The sensitivity of a predicted FEV1% <50% in predicting the risk of AECOPD in the future was 80.9%,while that in the real number of AECOPD events recorded was 62.8%,the difference being statistically significant (P=0.004).The sensitivity of CAT in predicting the severity of symptoms was 90%,while that of mMRC was 83.8%,and the difference was not statistically significant.Conclusions The COPD assessment method recommended by the global initiative for chronic obstructive pulmonary disease (GOLD) 2011 is complicated and should be simplified.CAT is more comprehensive and accurate than mMRC.The lung function classification is a better tool for predicting the risk of AECOPD in the future,and the number of AECOPD can be referred to when required.

  19. Versão em português do Chronic Respiratory Questionnaire: estudo da validade e reprodutibilidade Portuguese-language version of the Chronic Respiratory Questionnaire: a validity and reproducibility study

    OpenAIRE

    Graciane Laender Moreira; Fábio Pitta; Dionei Ramos; Cinthia Sousa Carvalho Nascimento; Danielle Barzon; Demétria Kovelis; Ana Lúcia Colange; Antonio Fernando Brunetto; Ercy Mara Cipulo Ramos

    2009-01-01

    OBJETIVO: Verificar a validade e a reprodutibilidade de uma versão em português do Chronic Respiratory Questionnaire (CRQ) em pacientes com DPOC. MÉTODOS: A versão em português do CRQ (fornecida pela Universidade de McMaster, detentora dos direitos do questionário) foi aplicada a 50 pacientes portadores de DPOC (32 homens; 70 ± 8 anos; VEF1 = 47 ± 18% predito) em dois momentos, com intervalo de uma semana. O CRQ tem quatro domínios (dispneia, fadiga, função emocional e autocontrole) e foi apl...

  20. Effect of doxycycline in patients of moderate to severe chronic obstructive pulmonary disease with stable symptoms

    Directory of Open Access Journals (Sweden)

    Prashant S Dalvi

    2011-01-01

    Full Text Available Background: The protease-antiprotease hypothesis proposes that inflammatory cells and oxidative stress in chronic obstructive pulmonary disease (COPD produce increased levels of proteolytic enzymes (neutrophil elastase, matrix metalloproteinases [MMP] which contribute to destruction of parenchyma resulting in progressive decline in forced expiratory volume in one second. Doxycycline, a tetracycline analogue, possesses anti-inflammatory properties and inhibits MMP enzymes. Objectives: To assess the effect of 4 weeks doxycycline in a dose of 100 mg once a day in patients of moderate to severe COPD with stable symptoms. Methods : In an interventional, randomized, observer-masked, parallel study design, the effect of doxycycline (100 mg once a day for 4 weeks was assessed in patients of COPD having stable symptoms after a run-in period of 4 weeks. The study participants in reference group did not receive doxycycline. The parameters were pulmonary functions, systemic inflammation marker C-reactive protein (CRP, and medical research council (MRC dyspnea scale. Use of systemic corticosteroids or antimicrobial agents was not allowed during the study period. Results: A total of 61 patients completed the study (31 patients in doxycycline group and 30 patients in reference group. At 4 weeks, the pulmonary functions significantly improved in doxycycline group and the mean reduction in baseline serum CRP was significantly greater in doxycycline group as compared with reference group. There was no significant improvement in MRC dyspnea scale in both groups at 4 weeks. Conclusion: The anti-inflammatory and MMP-inhibiting property of doxycycline might have contributed to the improvement of parameters in this study.

  1. Respiratory Health Symptoms and Lung Function among Road-side Hawkers in Serdang and Its Association with Traffic-Related Exposures

    Directory of Open Access Journals (Sweden)

    Nur Afiqah AMARAN

    2016-03-01

    Full Text Available Background: The main objective of this study was to determine the respiratory health symptoms and lung function among roadside hawkers in Serdang, Malaysia and its association with traffic-related exposures.Methods: This cross-sectional comparative study was conducted among 60 roadside hawkers while 60 restaurant workers were included as the comparative group in 2015. A questionnaire was used to collect background information and symptoms of respiratory health. All participants performed lung function tests. Personal exposure to traffic-related fine particulate matter (PM2.5 and carbon dioxide (CO were performed among a representative group of workers. All statistical analysis was performed using SPSS version 22.Results: The mean (standard deviation PM2.5 exposure among the roadside hawkers was 31.05 (1.62 μg/m3 while the exposure among the comparative group was 19.41 (1.51 μg/m3 (P<0.05. The mean exposure level of CO among the roadside hawkers was 2.42 (0.29 ppm compared to 1.51 (0.14 ppm among comparative group. FEV1 (litres (z=-1.96, P=0.04 of the exposed group was significantly lower than the comparative group. Respiratory symptoms such as wheezing, chest tightness, coughing and phlegm were significantly higher among exposed group (P<0.05. There were significant associations between the reporting of wheezing with PM2.5 (Odds Ratio, OR=10.39, 95% Confidence Interval, CI=2.67-40.41, working duration (OR=13.36, 95%CI=3.13- 57.03 and current smoking status (OR=3.34, 95%CI=1.04-10.67.Conclusion: Roadside hawkers are exposed to high traffic-related pollutants, had reduced lung function, and are at risk for increased respiratory health symptoms. The study suggested the importance of preventive management for this specific group of workers. Keywords: Fine Particulate Matter (PM2.5, Carbon Monoxide (CO, Respiratory health symptoms, Lung function, Roadside hawkers

  2. A prospective, community-based study on virologic assessment among elderly people with and without symptoms of acute respiratory infection

    NARCIS (Netherlands)

    Graat, J.M.; Schouten, E.G.; Heijnen, M.L.; Kok, F.J.; Pallast, E.G.; Greeff, de S.C.; Dorigo-Zetsma, J.W.

    2003-01-01

    Background and Objective: Community-based elderly studies concerning microbiology of acute respiratory infections are scarce. Data on subclinical infections are even totally absent, although asymptomatic persons might act as a source of respiratory infections. Methods: In a 1-year community-based st

  3. 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

  4. 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

  5. Acute inhibition of glial cells in the NTS does not affect respiratory and sympathetic activities in rats exposed to chronic intermittent hypoxia.

    Science.gov (United States)

    Costa, Kauê M; Moraes, Davi J A; Machado, Benedito H

    2013-02-16

    Recent studies suggest that neuron-glia interactions are involved in multiple aspects of neuronal activity regulation. In the nucleus tractus solitarius (NTS) neuron-glia interactions are thought to participate in the integration of autonomic responses to physiological challenges. However, it remains to be shown whether NTS glial cells might influence breathing and cardiovascular control, and also if they could be integral to the autonomic and respiratory responses to hypoxic challenges. Here, we investigated whether NTS glia play a tonic role in the modulation of central respiratory and sympathetic activities as well as in the changes in respiratory-sympathetic coupling induced by exposure to chronic intermittent hypoxia (CIH), a model of central autonomic and respiratory plasticity. We show that bilateral microinjections of fluorocitrate (FCt), a glial cell inhibitor, into the caudal and intermediate subnuclei of the NTS did not alter baseline respiratory and sympathetic parameters in in situ preparations of juvenile rats. Similar results were observed in rats previously exposed to CIH. Likewise, CIH-induced changes in respiratory-sympathetic coupling were unaffected by FCt-mediated inhibition. However, microinjection of FCt into the ventral medulla produced changes in respiratory frequency. Our results show that acute glial inhibition in the NTS does not affect baseline respiratory and sympathetic control. Additionally, we conclude that NTS glial cells may not be necessary for the continuous manifestation of sympathetic and respiratory adaptations to CIH. Our work provides evidence that neuron-glia interactions in the NTS do not participate in baseline respiratory and sympathetic control.

  6. Effect of smoking on lung function, respiratory symptoms and respiratory diseases amongst HIV-positive subjects: a cross-sectional study

    OpenAIRE

    Thabane Lehana; Smaill Fiona; McIvor Andrew; Carruthers Sue; Cui Qu; Smieja Marek

    2010-01-01

    Abstract Background Smoking prevalence in human immunodeficiency virus (HIV) positive subjects is about three times of that in the general population. However, whether the extremely high smoking prevalence in HIV-positive subjects affects their lung function is unclear, particularly whether smoking decreases lung function more in HIV-positive subjects, compared to the general population. We conducted this study to determine the association between smoking and lung function, respiratory sympto...

  7. An epidemiologic investigation of forced expiratory volume at 1 second and respiratory symptoms among employees of a toluene diisocyanate production plant.

    Science.gov (United States)

    Olsen, G W; Shellenberger, R; Bodner, K M; Flores, G H; Emmitte, J A; Bond, G G; Saunders, J H

    1989-08-01

    Pulmonary function tests were done and compared to current and past potential exposure levels of toluene diisocyanate (TDI) for 57 TDI manufacturing workers and 89 workers not exposed to TDI or other known respiratory hazards. The average TDI plant experience was 4.1 years (standard deviation = 2.8). Routine industrial hygiene measurements have shown TDI exposure below a time-weighted average of 0.005 parts per million and a short-term exposure level of 0.02 parts per million. A certified industrial hygienist ranked department and job classification by level of potential exposure to TDI (none, low, moderate, and high). A questionnaire was administered to determine the prevalence of respiratory symptoms and smoking habits. Using backward regression analysis, cumulative pack-years of cigarette smoking and prevalence of lower respiratory symptoms were statistically significant predictors of a standardized forced expiratory volume at 1 second observed v expected difference; however, TDI exposure, whether classified as current, highest career level, cumulative, or cumulative highest-to-date, was not associated with a decline in forced expiratory volume. PMID:2547915

  8. Acute effects of urban ambient air pollution on respiratory symptoms, asthma medication use, and doctor visits for asthma in a cohort of Australian children

    International Nuclear Information System (INIS)

    We enrolled a cohort of primary school children with a history of wheeze (n=148) in an 11-month longitudinal study to examine the relationship between ambient air pollution and respiratory morbidity. We obtained daily air pollution (ozone, particulate matter less than 10 μm, and nitrogen dioxide), meteorological, and pollen data. One hundred twenty-five children remained in the final analysis. We used logistic regression models to determine associations between air pollution and respiratory symptoms, asthma medication use, and doctor visits for asthma. There were no associations between ambient ozone concentrations and respiratory symptoms, asthma medication use, and doctor visits for asthma. There was, however, an association between PM10 concentrations and doctor visits for asthma (RR=1.11, 95% CI=1.04-1.19) and between NO2 concentration and wet cough (RR=1.05, 95% CI=1.003-1.10) in single-pollutant models. The associations remained significant in multipollutant models. There was no consistent evidence that children with wheeze, positive histamine challenge, and doctor diagnosis of asthma reacted differently to air pollution from children with wheeze and doctor diagnosis of asthma and children with wheeze only. There were significant associations between PM10 levels and doctor visits for asthma and an association between NO2 levels and the prevalence of wet cough. We were, however, unable to demonstrate that current levels of ambient air pollution in western Sydney have a coherent range of adverse health effects on children with a history of wheezing

  9. Different gastoroesophageal reflux symptoms of middle-aged to elderly asthma and chronic obstructive pulmonary disease (COPD) patients.

    Science.gov (United States)

    Shimizu, Yasuo; Dobashi, Kunio; Kusano, Motoyasu; Mori, Masatomo

    2012-03-01

    Symptomatic differences and the impact of gastroesophageal reflux disease (GERD) have not been clarified in patients with asthma and chronic obstructive pulmonary disease (COPD). The purpose of this study is to assess the differences of GERD symptoms among asthma, COPD, and disease control patients, and determine the impact of GERD symptoms on exacerbation of asthma or COPD by using a new questionnaire for GERD. A total of 120 subjects underwent assessment with the frequency scale for the symptoms of GERD (FSSG) questionnaire, including 40 age-matched patients in each of the asthma, COPD, and disease control groups. Asthma and control patients had more regurgitation-related symptoms than COPD patients (pbloated stomach was the chief symptom of COPD patients with GERD, and these symptoms were associated with disease exacerbations. The presence of GERD diagnosed by the total score of FSSG influences the exacerbation of COPD. GERD symptoms differed between asthma and COPD patients, and the presence of GERD diagnosed by the FSSG influences the exacerbation of COPD. PMID:22448100

  10. Patient-reported outcomes to assess the efficacy of extended-release guaifenesin for the treatment of acute respiratory tract infection symptoms

    Directory of Open Access Journals (Sweden)

    Albrecht Helmut

    2012-12-01

    Full Text Available Abstract Background Guaifenesin is a component of medicines used to improve symptoms associated with upper respiratory tract infections. Patient-reported outcome instruments are valuable for evaluating symptom improvements; however, a validated tool to assess efficacy of mucoactive drugs does not exist. We compared the efficacy of extended-release guaifenesin with placebo for treatment of symptoms of upper respiratory tract infection using subjective efficacy assessments in a pilot study and confirmed precision of assessments in a validation study. Methods The pilot study was a randomized, double-blind study where patients were dosed with either 1200 mg extended-release guaifenesin (n = 188 or placebo (n = 190, every 12 hours for 7 days. Efficacy was assessed using subjective measures including the Daily Cough and Phlegm Diary, the Spontaneous Symptom Severity Assessment and the Wisconsin Upper Respiratory Symptom Survey. End-of-study assessments were completed by patients and investigator. The validation study consisted of two phases. In Phase I, subjects completed interviews to gather evidence to support the content validity of the Daily Cough and Phlegm Diary, the Spontaneous Symptom Severity Assessment and Patient’s End-of-Treatment Assessment. Phase II examined the psychometric properties of assessments evaluated in Phase I of the validation study using data from the pilot study. Results Subjective measures of efficacy at Day 4 showed the most prominent difference between treatment groups, in favor of guaifenesin. The 8-symptom related questions (SUM8 in the Daily Cough and Phlegm Diary, analyzed as a composite score appeared to be the strongest candidate endpoint for further evaluation. Results from the interviews in Phase I supported the content of the assessments which were validated during Phase II. Treatments were well tolerated. Conclusions Results from the clinical pilot and validation studies showed that the SUM8 diary

  11. IDENTIFICATION OF UNDERLYING CAUSES OF CHRONIC UNSPECIFIC UPPER GASTROINTESTINAL-RELATED SYMPTOMS IN CHILDREN, A PILOT STUDY.

    Science.gov (United States)

    Fouad, Hanan M; Abdulla, Nour A; El Naghy, Suzan; Hassan, Ehsan H; Abd El-Hamid, Amal

    2016-04-01

    Upper gastrointestinal tract (GIT) symptoms are not disease specific and of limited value in the differentiation of GIT disorders. The present study aimed to determine the etiology of chronic unspecific symptoms in children and to test the need for upper endoscopy in diagnosis. This is a prospective study for 30 Egyptian children presented with chronic upper GIT symptoms for at least 2 months. History regarding severity and frequency of GIT symptoms were asked for. Children with known disorder that explains presenting symptoms were excluded. Upper GIT endoscopy wa performed and 5 biopsies were obtained for pathological examination and for Hpylori testing. The results showed that children age ranged between 2.5-18 years with mean ± SD of 13.6 ± 3.4 and 63.3% were females. The main complaints were epigastric pain in 43.3%, hematemesis in 30% and vomiting in 26.7%. Motility disorders were diagnosed in 66.7% children; in the form of GERD in 63.3% and achalasia in one. Complication of GERD in the form of erosive esophagitis was present in 15.8% children, while Barrett's esophagus was not observed. H. pylori infection was diagnosed in 80% histologically. Eosinophilic esophagitis was not detected. PMID:27363051

  12. Atypical Antipsychotics in the Treatment of Depressive and Psychotic Symptoms in Patients with Chronic Schizophrenia: A Naturalistic Study

    Directory of Open Access Journals (Sweden)

    Marco Innamorati

    2013-01-01

    Full Text Available Objectives. The aim of this naturalistic study was to investigate whether treatment with clozapine and other atypical antipsychotics for at least 2 years was associated with a reduction in psychotic and depressive symptoms and an improvement in chronic schizophrenia patients’ awareness of their illness. Methods. Twenty-three adult outpatients (15 men and 8 women treated with clozapine and 23 patients (16 men and 7 women treated with other atypical antipsychotics were included in the study. Psychotic symptoms were evaluated using the Positive and Negative Syndrome Scale (PANSS, depressive symptoms were assessed with the Calgary Depression Scale for Schizophrenia (CDSS, and insight was assessed with the Scale to Assess Unawareness of Mental Disorder (SUMD. Results. The sample as a whole had a significant reduction in positive, negative, and general symptoms, whereas the reduction in depression was significant only for patients with CDSS scores of 5 and higher at the baseline. At the follow-up, patients treated with other atypical antipsychotics reported a greater reduction in depression than patients treated with clozapine, but not when limiting the analyses to those with clinically relevant depression. Conclusions. Atypical antipsychotics may be effective in reducing psychotic and depressive symptoms and in improving insight in patients with chronic schizophrenia, with no differences in the profiles of efficacy between compounds.

  13. Functional Correlates of childhood maltreatment and symptom severity during affective theory of mind tasks in chronic depression.

    Science.gov (United States)

    Hentze, Charlotte; Walter, Henrik; Schramm, Elisabeth; Drost, Sarah; Schoepf, Dieter; Fangmeier, Thomas; Mattern, Margarete; Normann, Claus; Zobel, Ingo; Schnell, Knut

    2016-04-30

    Among multiple etiological factors of depressive disorders, childhood maltreatment (CM) gains increasing attention as it confers susceptibility for depression and predisposes to chronicity. CM assumedly inhibits social-cognitive development, entailing interactional problems as observed in chronic depression (CD), especially in affective theory of mind (ToM). However, the extent of CM among CD patients varies notably as does the severity of depressive symptoms. We tested whether the extent of CM or depressive symptoms correlates with affective ToM functions in CD patients. Regional brain activation measured by functional magnetic resonance imaging during an affective ToM task was tested for correlation with CM, assessed by the Childhood Trauma Questionnaire (CTQ), and symptom severity, assessed by the Montgomery-Åsberg Depression Rating Scale (MADRS), in 25 unmedicated CD patients (mean age 41.52, SD 11.13). Amygdala activation during affective ToM correlated positively with CTQ total scores, while (para)hippocampal response correlated negatively with MADRS scores. Our findings suggest that differential amygdala activation in affective ToM in CD is substantially modulated by previous CM and not by the pathophysiological equivalents of current depressive symptoms. This illustrates the amygdala's role in the mediation of CM effects. The negative correlation of differential (para)hippocampal activation and depressive symptom severity indicates reduced integration of interactional experiences during depressive states.

  14. White matter abnormalities are associated with chronic postconcussion symptoms in blast-related mild traumatic brain injury.

    Science.gov (United States)

    Miller, Danielle R; Hayes, Jasmeet P; Lafleche, Ginette; Salat, David H; Verfaellie, Mieke

    2016-01-01

    Blast-related mild traumatic brain injury (mTBI) is a common injury among Iraq and Afghanistan military veterans due to the frequent use of improvised explosive devices. A significant minority of individuals with mTBI report chronic postconcussion symptoms (PCS), which include physical, emotional, and cognitive complaints. However, chronic PCS are nonspecific and are also associated with mental health disorders such as posttraumatic stress disorder (PTSD). Identifying the mechanisms that contribute to chronic PCS is particularly challenging in blast-related mTBI, where the incidence of comorbid PTSD is high. In this study, we examined whether blast-related mTBI is associated with diffuse white matter changes, and whether these neural changes are associated with chronic PCS. Ninety Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) veterans were assigned to one of three groups including a blast-exposed no--TBI group, a blast-related mTBI without loss of consciousness (LOC) group (mTBI--LOC), and a blast-related mTBI with LOC group (mTBI + LOC). PCS were measured with the Rivermead Postconcussion Questionnaire. Results showed that participants in the mTBI + LOC group had more spatially heterogeneous white matter abnormalities than those in the no--TBI group. These white matter abnormalities were significantly associated with physical PCS severity even after accounting for PTSD symptoms, but not with cognitive or emotional PCS severity. A mediation analysis revealed that mTBI + LOC significantly influenced physical PCS severity through its effect on white matter integrity. These results suggest that white matter abnormalities are associated with chronic PCS independent of PTSD symptom severity and that these abnormalities are an important mechanism explaining the relationship between mTBI and chronic physical PCS.

  15. School absence and treatment in school children with respiratory symptoms in the Netherlands: Data from the Child Health Monitoring System

    NARCIS (Netherlands)

    Spee-van Der Wekke, J.; Meulmeester, J.F.; Radder, J.J.; Verloove-Vanhorick, S.P.

    1998-01-01

    Study objective - To assess the prevalence of respiratory problems, and the relation of these problems with school attendance, medicine use, and medical treatment. Design - The Child Health Monitoring System. Setting - Nineteen public health services across the Netherlands. Participants - 5186 schoo

  16. Prevalence, severity, and importance of physical and emotional symptoms in chronic hemodialysis patients.

    Science.gov (United States)

    Weisbord, Steven D; Fried, Linda F; Arnold, Robert M; Fine, Michael J; Levenson, David J; Peterson, Rolf A; Switzer, Galen E

    2005-08-01

    The prevalence, severity, and clinical significance of physical and emotional symptoms in patients who are on maintenance hemodialysis remain incompletely characterized. This study sought to assess symptoms and their relationship to quality of life and depression. The recently developed Dialysis Symptom Index was used to assess the presence and the severity of 30 symptoms. The Illness Effects Questionnaire and Beck Depression Inventory were used to evaluate quality of life and depression, respectively. Correlations among symptom burden, symptom severity, quality of life, and depression were assessed using Spearman correlation coefficient. A total of 162 patients from three dialysis units were enrolled. Mean age was 62 y, 48% were black, 62% were men, and 48% had diabetes. The median number of symptoms was 9.0 (interquartile range 6 to 13). Dry skin, fatigue, itching, and bone/joint pain each were reported by > or =50% of patients. Seven additional symptoms were reported by >33% of patients. Sixteen individual symptoms were described as being more than "somewhat bothersome." Overall symptom burden and severity each were correlated directly with impaired quality of life and depression. In multivariable analyses adjusting for demographic and clinical variables including depression, associations between symptoms and quality of life remained robust. Physical and emotional symptoms are prevalent, can be severe, and are correlated directly with impaired quality of life and depression in maintenance hemodialysis patients. Incorporating a standard assessment of symptoms into the care provided to maintenance hemodialysis patients may provide a means to improve quality of life in this patient population.

  17. 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.

  18. The Association of Chronic Hepatitis C with Respiratory Microbiota Disturbance on the Basis of Decreased Haemophilus Spp. Colonization.

    Science.gov (United States)

    Kosikowska, Urszula; Biernasiuk, Anna; Korona-Głowniak, Izabela; Kiciak, Sławomir; Tomasiewicz, Krzysztof; Malm, Anna

    2016-01-01

    BACKGROUND Haemophilus species are the most common microbiota in humans. The aim of this paper was to investigate Haemophilus spp., mainly H. parainfluenzae prevalence, in the upper respiratory tract of chronic hepatitis C (CHC-positive) patients with or without therapy using pegylated interferon alfa and ribavirin. MATERIAL AND METHODS We collected 462 samples from 54 healthy people and 100 CHC-positive patients at various stages: before (group A), during (group B), and after (group C) antiviral therapy. Identification of bacterial isolates including biotypes and antimicrobials susceptibility was accomplished by means of standard microbiological methods. RESULTS In 70.4% of healthy people (control group) and in 27.0% of CHC-positive patients, the presence of haemophili, mainly H. parainfluenzae was observed, and those differences were statistically significant (p<0.0001). Statistically significant differences in Haemophilus spp. colonization were also observed among healthy people and CHC-positive patients from group A (p=0.0012) and from B or C groups (p<0.0001). Resistance to ampicillin in beta-lactamase-positive isolates and multidrug resistance (MDR) of H. parainfluenzae was detected mainly in group A. CONCLUSIONS The obtained data suggest that chronic hepatitis C, together with antiviral therapy, may influence the respiratory tract microbiota composition as found using haemophili, mainly H. parainfluenzae. PMID:26912163

  19. Effect of intensive aerobic exercise on respiratory capacity and walking ability with chronic stroke patients: a randomized controlled pilot trial

    Science.gov (United States)

    Bang, Dae-Hyouk; Son, Young-Lan

    2016-01-01

    [Purpose] To investigate the effects of intensive aerobic exercise on respiratory capacity and walking ability in chronic stroke patients. [Subjects and Methods] The subjects were randomly assigned to an experimental group (n=6) or a control group (n=6). Patients in the experimental group received intensive aerobic exercise for 30 minutes and traditional physical therapy once a day, five days a week, for four weeks. The control group received aerobic exercise for 30 minutes and traditional physical therapy for 30 minutes a day, five days a week, for four weeks. [Results] After the intervention, both groups showed significant improvements in the forced vital capacity, forced expiratory volume in one second, 10-meter walking test, and six-minute walking test over the baseline results. The comparison of the two groups after the intervention revealed that the experimental group showed more significant improvements in the forced vital capacity, forced expiratory volume in one second, and six-minute walking test. There was no significant difference in saturation pulse oximetry oxygen and 10-meter walking test between the groups. [Conclusion] The results of this study suggest that intensive aerobic exercise has a positive effect on respiratory capacity and walking endurance in patients with chronic stroke.

  20. Idiopathic chronic eosinophilic pneumonia

    OpenAIRE

    Cordier Jean-François; Marchand Eric

    2006-01-01

    Abstract Idiopathic chronic eosinophilic pneumonia (ICEP) is characterized by subacute or chronic respiratory and general symptoms, alveolar and/or blood eosinophilia, and peripheral pulmonary infiltrates on chest imaging. Eosinophilia is present in most cases, usually in excess of 1000/mm3. In absence of significant blood eosinophilia, a diagnosis of ICEP is supported by the demonstration of bronchoalveolar lavage eosinophilia. ICEP is typically associated with eosinophil counts higher than ...

  1. In vivo evaluation of adeno-associated virus gene transfer in airways of mice with acute or chronic respiratory infection.

    Science.gov (United States)

    Myint, Melissa; Limberis, Maria P; Bell, Peter; Somanathan, Suryanarayan; Haczku, Angela; Wilson, James M; Diamond, Scott L

    2014-11-01

    Patients with cystic fibrosis (CF) often suffer chronic lung infection with concomitant inflammation, a setting that may reduce the efficacy of gene transfer. While gene therapy development for CF often involves viral-based vectors, little is known about gene transfer in the context of an infected airway. In this study, three mouse models were established to evaluate adeno-associated virus (AAV) gene transfer in such an environment. Bordetella bronchiseptica RB50 was used in a chronic, nonlethal respiratory infection in C57BL/6 mice. An inoculum of ∼10(5) CFU allowed B. bronchiseptica RB50 to persist in the upper and lower respiratory tracts for at least 21 days. In this infection model, administration of an AAV vector on day 2 resulted in 2.8-fold reduction of reporter gene expression compared with that observed in uninfected controls. Postponement of AAV administration to day 14 resulted in an even greater (eightfold) reduction of reporter gene expression, when compared with uninfected controls. In another infection model, Pseudomonas aeruginosa PAO1 was used to infect surfactant protein D (SP-D) or surfactant protein A (SP-A) knockout (KO) mice. With an inoculum of ∼10(5) CFU, infection persisted for 2 days in the nasal cavity of either mouse model. Reporter gene expression was approximately ∼2.5-fold lower compared with uninfected mice. In the SP-D KO model, postponement of AAV administration to day 9 postinfection resulted in only a two fold reduction in reporter gene expression, when compared with expression seen in uninfected controls. These results confirm that respiratory infections, both ongoing and recently resolved, decrease the efficacy of AAV-mediated gene transfer. PMID:25144316

  2. 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...

  3. Associations of indoor carbon dioxide concentrations and environmental susceptibilities with mucous membrane and lower respiratory building related symptoms in the BASE study: Analyses of the 100 building dataset

    Energy Technology Data Exchange (ETDEWEB)

    Erdmann, Christine A.; Apte, Michael G.

    2003-09-01

    Using the US EPA 100 office-building BASE Study dataset, they conducted multivariate logistic regression analyses to quantify the relationship between indoor CO{sub 2} concentrations (dCO{sub 2}) and mucous membrane (MM) and lower respiratory system (LResp) building related symptoms, adjusting for age, sex, smoking status, presence of carpet in workspace, thermal exposure, relative humidity, and a marker for entrained automobile exhaust. In addition, they tested the hypothesis that certain environmentally-mediated health conditions (e.g., allergies and asthma) confer increased susceptibility to building related symptoms within office buildings. Adjusted odds ratios (ORs) for statistically significant, dose-dependent associations (p < 0.05) for dry eyes, sore throat, nose/sinus congestion, and wheeze symptoms with 100 ppm increases in dCO{sub 2} ranged from 1.1 to 1.2. These results suggest that increases in the ventilation rates per person among typical office buildings will, on average, reduce the prevalence of several building related symptoms by up to 70%, even when these buildings meet the existing ASHRAE ventilation standards for office buildings. Building occupants with certain environmentally-mediated health conditions are more likely to experience building related symptoms than those without these conditions (statistically significant ORs ranged from 2 to 11).

  4. Recurrent short sleep, chronic insomnia symptoms and salivary cortisol: A 10-year follow-up in the Whitehall II study.

    OpenAIRE

    Abell, J. G.; Shipley, M J; Ferrie, J. E.; Kivimäki, M; Kumari, M.

    2016-01-01

    Although an association between both sleep duration and disturbance with salivary cortisol has been suggested, little is known about the long term effects of poor quality sleep on diurnal cortisol rhythm. The aim of this study was to examine the association of poor quality sleep, categorised as recurrent short sleep duration and chronic insomnia symptoms, with the diurnal release of cortisol. We examined this in 3314 participants from an occupational cohort, originally recruited in 1985-1989....

  5. Neuromuscular strain as a contributor to cognitive and other symptoms in chronic fatigue syndrome: hypothesis and conceptual model

    OpenAIRE

    Rowe, Peter C.; Fontaine, Kevin R.; Violand, Richard L.

    2013-01-01

    Individuals with chronic fatigue syndrome (CFS) have heightened sensitivity and increased symptoms following various physiologic challenges, such as orthostatic stress, physical exercise, and cognitive challenges. Similar heightened sensitivity to the same stressors in fibromyalgia (FM) has led investigators to propose that these findings reflect a state of central sensitivity. A large body of evidence supports the concept of central sensitivity in FM. A more modest literature provides partia...

  6. Frequency of depression and somatic symptoms in patients on interferon alpha/ribavirin for chronic hepatitis C

    International Nuclear Information System (INIS)

    Large numbers of patients suffering from Chronic Hepatitis C (HCV) are seeking treatment with interferon alpha (IFN) because of significant advances in overall improvement in the course of HCV and its complications. Objectives were to estimate the frequency of depression and somatic symptoms in patients on interferon alpha/ribavirin treatment for chronic hepatitis C. Methods: It was an observational study conducted in the out-patient Department of Gastroenterology Shaikh Zayed Hospital, Lahore during a period of three months, i.e., from September to November 2008. One hundred consecutive patients undergoing interferon alpha/ ribavirin treatment for chronic HCV were included in the study. All patients, irrespective of age, sex or duration of treatment were administered with a check list of common physical complaints and DSM-IV symptoms for Major Depressive Episode. Results: Out of a total of 100 subjects 37 were male and 63 were female. In all, 39 (39%) patients fulfilled the diagnostic criteria of DSM-IV for Major Depressive Episode. Major Depression was more common in female 28 (44.4%) as compared to male 11 (28.7%) patients. Somatic symptoms were common in all the patients but they were reported more frequently by patients with Major Depression compared to those without Major Depression. Myalgias, headache, joint pain, nausea/vomiting, abdominal pain and palpitation were the most common physical symptoms. Conclusion: Major Depression and somatic complaints are a common consequence of interferon alpha/ribavirin treatment for chronic hepatitis C. All patients receiving this treatment should be periodically assessed for the detection of these side effects to promptly address relevant treatment options. (author)

  7. 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

  8. Depressive symptoms and pain evaluations among persons with chronic pain: catastrophizing, but not pain acceptance, shows significant effects.

    Science.gov (United States)

    Richardson, Elizabeth J; Ness, Timothy J; Doleys, Daniel M; Baños, James H; Cianfrini, Leanne; Richards, J Scott

    2009-12-15

    Cognitive factors such as catastrophic thoughts regarding pain, and conversely, one's acceptance of that pain, may affect emotional functioning among persons with chronic pain conditions. The aims of the present study were to examine the effects of both catastrophizing and acceptance on affective ratings of experimentally induced ischemic pain and also self-reports of depressive symptoms. Sixty-seven individuals with chronic back pain completed self-report measures of catastrophizing, acceptance, and depressive symptoms. In addition, participants underwent an ischemic pain induction procedure and were asked to rate the induced pain. Catastrophizing showed significant effects on sensory and intensity but not affective ratings of the induced pain. Acceptance did not show any significant associations, when catastrophizing was also in the model, with any form of ratings of the induced pain. Catastrophizing, but not acceptance, was also significantly associated with self-reported depressive symptoms when these two variables were both included in a regression model. Overall, results indicate negative thought patterns such as catastrophizing appear to be more closely related to outcomes of perceived pain severity and affect in persons with chronic pain exposed to an experimental laboratory pain stimulus than does more positive patterns as reflected in measures of acceptance.

  9. 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.

  10. Chronic aspiration of gastric and duodenal contents and their effects on inflammatory cytokine production in respiratory system of rats.

    Directory of Open Access Journals (Sweden)

    Mitra Samareh Fekri

    2014-02-01

    Full Text Available Gastroesophageal reflux disease (GERD is defined with clinical symptoms of heart burning and regurgitation. It may be associated with external esophageal symptoms such as chronic cough, asthma, laryngitis, chronic lung disease, sinusitis and pulmonary fibrosis. In the present study, rats with chronic aspiration of gastroduodenal contents were studied for cellular phenotypes and cytokine concentrations in bronchoalveolar lavage and lung tissue. Thirty-six male Albino N-MRI rats were randomly divided into six groups. After anesthesia and tracheal intubation, the animals received either 0.5ml/kg of normal saline (control, gastric juice, pepsin, hydrochloric acid or bile salts by injection into their lungs twice a week for 8 weeks. In sham group nothing was injected. Thereafter, cellular phenotypes and cytokine concentrations of Interleukine (IL-1α, IL-1β, Transforming Growth Factor (TGF-β, Tumor Necrosis Factor (TNF-α, and IL-6 were assessed in bronchoalveolar lavage and lung tissue homogenates. The numbers of epithelial cells, macrophages, neutrophils and lymphocytes in BAL and levels of cytokines IL-1α, IL-6, TNF-α and TGF-β in BAL and lung tissue of test groups were significantly higher than the control group. Aspiration of bile salts caused more cytokine levels and inflammatory cells compared to other reflux components. It can be concluded that GERD with increased cytokines and inflammatory cells in lung could cause or exacerbate asthma and pulmonary fibrosis.

  11. 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.

  12. 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

  13. Asthma and pneumonia among children less than five years with acute respiratory symptoms in Mulago Hospital, Uganda

    DEFF Research Database (Denmark)

    Nantanda, Rebecca; Tumwine, James K; Ndeezi, Grace;

    2013-01-01

    Pneumonia is considered the major cause of mortality among children with acute respiratory disease in low-income countries but may be over-diagnosed at the cost of under-diagnosing asthma. We report the magnitude of asthma and pneumonia among "under-fives" with cough and difficulty breathing, based...

  14. Epidemiology of respiratory symptoms in children with Down syndrome: A nationwide prospective web-based parent-reported study

    NARCIS (Netherlands)

    Verstegen, R.H.J. (Ruud H.J.); R.W.N.M. Hout; E. de Vries (E.)

    2014-01-01

    textabstractBackground: Children with Down syndrome suffer from recurrent respiratory tract and ear-nose-throat complaints that influence daily life. Little is known about the frequency of these complaints, as well as their relation to co-morbidity and ageing.Methods/design: A prospective web-based

  15. Low prevalence of Chlamydia pneumoniae and Mycoplasma pneumoniae among patients with symptoms of respiratory tract infections in Dutch general practices.

    NARCIS (Netherlands)

    Meijer, A.; Dagnelie, C.F.; Jong, J.C. de; Vries, A. de; Besteboer, T.M.; Loon, A.M. van; Bartelds, A.I.M.; Ossewaarde, J.M.

    2000-01-01

    Acute respiratory disease is one of the most common reasons to consult a general practitioner. A substantial part of these diseases cannot be explained by an infection with a virus or a common pathogenic bacterium. To study this diagnostic deficit, the prevalence of Chlamydia pneumoniae and Mycoplas

  16. Air pollution from traffic and the development of respiratory infections and asthmatic and allergic symptoms in children

    NARCIS (Netherlands)

    Brauer, M; Hoek, G; Van Vliet, P; Meliefste, K; Fischer, PH; Wijga, A; Koopman, LP; Neijens, HJ; Gerritsen, J; Kerkhof, M; Heinrich, J; Bellander, T; Brunekreef, B

    2002-01-01

    Despite the important contribution of traffic sources to urban air quality, relatively few studies have evaluated the effects of traffic-related air pollution on health, such as its influence on the development of asthma and other childhood respiratory diseases. We examined the relationship between

  17. 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...

  18. Psychopathology and quality of life burden in chronic daily headache: influence of migraine symptoms

    OpenAIRE

    Autret, A.; Roux, S.; Rimbaux-Lepage, S.; Valade, D; Debiais, S.; ,

    2010-01-01

    The aim of this study is to compare the psychopathology and the quality of life of chronic daily headache patients between those with migraine headache and those with tension-type headache. We enrolled 106 adults with chronic daily headache (CDH) who consulted for the first time in specialised centres. The patients were classified according to the IHS 2004 criteria and the propositions of the Headache Classification Committee (2006) with a computed algorithm: 8 had chronic migraine (without m...

  19. Family Functioning in First-Episode and Chronic Psychosis: The Role of Patient's Symptom Severity and Psychosocial Functioning.

    Science.gov (United States)

    Koutra, Katerina; Triliva, Sofia; Roumeliotaki, Theano; Basta, Maria; Lionis, Christos; Vgontzas, Alexandros N

    2016-08-01

    The aim of the present study was to assess the relationship between illness-related characteristics, such as symptom severity and psychosocial functioning, and specific aspects of family functioning both in patients experiencing their first episode of psychosis (FEP) and chronically ill patients. A total of 50 FEP and 50 chronic patients diagnosed with schizophrenia or bipolar disorder (most recent episode manic severe with psychotic features) and their family caregivers participated in the study. Family functioning was evaluated in terms of cohesion and flexibility (FACES IV Package), expressed emotion (FQ), family burden (FBS) and caregivers' psychological distress (GHQ-28). Patients' symptom severity (BPRS) and psychosocial functioning (GAS) were assessed by their treating psychiatrist within 2 weeks from the caregivers' assessment. Increased symptom severity was associated with greater dysfunction in terms of family cohesion and flexibility (β coefficient -0.13; 95 % CI -0.23, -0.03), increased caregivers' EE levels on the form of emotional overinvolvement (β coefficient 1.03; 95 % CI 0.02, 2.03), and psychological distress (β coefficient 3.37; 95 % CI 1.29, 5.45). Family burden was found to be significantly related to both symptom severity (β coefficient 3.01; 95 % CI 1.50, 4.51) and patient's functioning (β coefficient -2.04; 95 % CI -3.55, -0.53). No significant interaction effect of chronicity was observed in the afore-mentioned associations. These findings indicate that severe psychopathology and patient's low psychosocial functioning are associated with poor family functioning. It appears that the effect for family function is significant from the early stages of the illness. Thus, early psychoeducational interventions should focus on patients with severe symptomatology and impaired functioning and their families. PMID:26286079

  20. Family Functioning in First-Episode and Chronic Psychosis: The Role of Patient's Symptom Severity and Psychosocial Functioning.

    Science.gov (United States)

    Koutra, Katerina; Triliva, Sofia; Roumeliotaki, Theano; Basta, Maria; Lionis, Christos; Vgontzas, Alexandros N

    2016-08-01

    The aim of the present study was to assess the relationship between illness-related characteristics, such as symptom severity and psychosocial functioning, and specific aspects of family functioning both in patients experiencing their first episode of psychosis (FEP) and chronically ill patients. A total of 50 FEP and 50 chronic patients diagnosed with schizophrenia or bipolar disorder (most recent episode manic severe with psychotic features) and their family caregivers participated in the study. Family functioning was evaluated in terms of cohesion and flexibility (FACES IV Package), expressed emotion (FQ), family burden (FBS) and caregivers' psychological distress (GHQ-28). Patients' symptom severity (BPRS) and psychosocial functioning (GAS) were assessed by their treating psychiatrist within 2 weeks from the caregivers' assessment. Increased symptom severity was associated with greater dysfunction in terms of family cohesion and flexibility (β coefficient -0.13; 95 % CI -0.23, -0.03), increased caregivers' EE levels on the form of emotional overinvolvement (β coefficient 1.03; 95 % CI 0.02, 2.03), and psychological distress (β coefficient 3.37; 95 % CI 1.29, 5.45). Family burden was found to be significantly related to both symptom severity (β coefficient 3.01; 95 % CI 1.50, 4.51) and patient's functioning (β coefficient -2.04; 95 % CI -3.55, -0.53). No significant interaction effect of chronicity was observed in the afore-mentioned associations. These findings indicate that severe psychopathology and patient's low psychosocial functioning are associated with poor family functioning. It appears that the effect for family function is significant from the early stages of the illness. Thus, early psychoeducational interventions should focus on patients with severe symptomatology and impaired functioning and their families.

  1. Translation and validation of the Dutch language version of the CDC Symptom Inventory for assessment of Chronic Fatigue Syndrome (CFS

    Directory of Open Access Journals (Sweden)

    Vermeulen Ruud CW

    2006-10-01

    Full Text Available Abstract Background In a study by Wagner et al., the CDC Symptom Inventory was validated in a population selected from the inhabitants of a city in the USA, and proofed reliable for the assessment of the accompanying symptoms of CFS. The Dutch translation of the CDC Symptom Inventory is compared to the original and the psychometric properties are presented for patients in a tertiary care setting. Methods One hundred thirty-nine consecutive patients who visited the CFS Center Amsterdam for the first time were asked to complete the CDC Symptom Inventory in the Dutch Language Version (DLV together with the usual set of questionnaires. Sixty-one patients had Chronic Fatigue (CF and 78 patients fulfilled the criteria for CFS. Forty-three healthy accompanying persons completed the CDC Symptom Inventory DLV, the Physical Functioning scale of the Medical Outcome Survey Short Form-36 DLV, and the Fatigue and Concentration scales of the Checklist Individual Strength (CIS-20. Results The healthy controls group contained fewer women and was overall older than the patient groups. The influence of gender on the CDC Symptom Inventory DLV was significant but the effect of age was not. The Dutch version had a good internal consistency and convergent validity. The results were comparable to the original English version, but the sex-related difference needs further study. Conclusion The Dutch version of the CDC Symptom Inventory is a reliable tool for the assessment of the secondary criteria for CFS. The results show that it is comparable to the outcome of studies in English speaking countries.

  2. Sex differences in trauma symptoms, body image and intensity of pain in a Polish sample of patients suffering from chronic pain.

    Science.gov (United States)

    Rzeszutek, Marcin; Oniszczenko, Włodzimierz; Schier, Katarzyna; Biernat-Kałuża, Edyta; Gasik, Robert

    2016-10-01

    The main goal of the current study was to investigate sex differences in the relationship between the level of trauma symptoms appearing in posttraumatic stress disorder (PTSD) and intensity of pain in a sample of 300 Polish patients suffering from chronic pain, specifically rheumatoid arthritis and lower back pain. We also focused on participants' body image with body esteem as a mediator. To assess the intensity of pain among participants, we used the Numerical Rating Scale. The level of trauma symptoms was assessed with the PTSD Factorial Version Inventory. To measure body image among participants, we used the Body Esteem Scale. The results of our study suggest that trauma symptoms and body image dimensions were significant predictors of pain intensity among men suffering from chronic pain. Moreover, trauma symptoms and age were significant predictors of pain intensity among women suffering from chronic pain. Finally, we demonstrated that sex differentiates the reaction to chronic pain. PMID:26609737

  3. Chronic Pelvic Ischemia: Contribution to the Pathogenesis of Lower Urinary Tract Symptoms (LUTS): A New Target for Pharmacological Treatment?

    Science.gov (United States)

    Andersson, Karl-Erik; Nomiya, Masanori; Yamaguchi, Osamu

    2015-01-01

    The incidence of lower urinary tract symptoms, including overactive bladder (OAB), is continuing to rise, and is associated with a negative impact on quality of life and a heavy economic burden. A major risk factor for OAB is advancing age. The etiology of OAB is multifactorial and appears to involve myogenic, neurogenic, and urotheliogenic factors. In this article, we review the strengthening preclinical evidence supporting the contribution of chronic pelvic ischemia to the pathogenesis of OAB. In animal models, chronic ischemia induced by arterial injury and a high-fat diet upregulates markers of oxidative stress and proinflammatory cytokines in the urothelium and lamina propria, and leads to increased expression of nerve growth factor. These processes result in increased afferent activity and an increased frequency of micturition, reflecting a state of bladder hyperactivity. In severe, prolonged cases, bladder overactivity may develop into underactivity. Antimuscarinic therapies are the mainstay of OAB treatment, but their usefulness is limited by modest efficacy and troublesome side-effects. Our increasing understanding of the contribution of chronic ischemia to OAB is leading toward novel therapeutic options targeting chronic pelvic ischemia and its morphological, functional, and oxidative consequences. Preclinical trials have demonstrated encouraging results with α1 -adrenoreceptor blockade, phosphodiesterase type 5 inhibition, β3 -adrenoreceptor agonism, free radical scavenging, and stem cell therapy, in preventing morphological, biochemical and functional changes induced by chronic bladder ischemia. PMID:26663644

  4. 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.

  5. Chronic air-flow limitation does not increase respiratory epithelial permeability assessed by aerosolized solute, but smoking does

    International Nuclear Information System (INIS)

    To determine the separate influences of smoking and severe air-flow limitation on aerosol deposition and respiratory epithelial permeability, we studied 26 normal nonsmokers, 12 smokers without airway obstruction, 12 nonsmokers with chronic obstructive pulmonary disease (COPD), and 11 smokers with COPD. We aerosolized 99mTc-labeled diethylene triamine pentaacetic acid to particles approximately 1 micron activity median aerodynamic diameter. Levels of radioactivity were plotted semilogarithmically against time to calculate clearance as percent per minute. The distribution of radioactivity was homogeneous in control subjects and in smokers, but patchy in both groups with COPD. No difference was found between clearances of the control group (1.18 +/- 0.31% min-1), and nonsmoker COPD group (1.37 +/- 0.82% min-1), whereas values in smokers without COPD (4.00 +/- 1.70% min-1) and smokers with COPD (3.62 +/- 2.88% min-1) were significantly greater than in both nonsmoking groups. We conclude that (1) small particles appear to deposit peripherally, even with severe COPD; (2) respiratory epithelial permeability is normal in nonsmokers with COPD; (3) smoking increases permeability by a mechanism unrelated to air-flow limitation

  6. Chronic effects of air pollution on respiratory health in Southern California children: findings from the Southern California Children's Health Study.

    Science.gov (United States)

    Chen, Zhanghua; Salam, Muhammad T; Eckel, Sandrah P; Breton, Carrie V; Gilliland, Frank D

    2015-01-01

    Outdoor air pollution is one of the leading contributors to adverse respiratory health outcomes in urban areas around the world. Children are highly sensitive to the adverse effects of air pollution due to their rapidly growing lungs, incomplete immune and metabolic functions, patterns of ventilation and high levels of outdoor activity. The Children's Health Study (CHS) is a continuing series of longitudinal studies that first began in 1993 and has focused on demonstrating the chronic impacts of air pollution on respiratory illnesses from early childhood through adolescence. A large body of evidence from the CHS has documented that exposures to both regional ambient air and traffic-related pollutants are associated with increased asthma prevalence, new-onset asthma, risk of bronchitis and wheezing, deficits of lung function growth, and airway inflammation. These associations may be modulated by key genes involved in oxidative-nitrosative stress pathways via gene-environment interactions. Despite successful efforts to reduce pollution over the past 40 years, air pollution at the current levels still brings many challenges to public health. To further ameliorate adverse health effects attributable to air pollution, many more toxic pollutants may require regulation and control of motor vehicle emissions and other combustion sources may need to be strengthened. Individual interventions based on personal susceptibility may be needed to protect children's health while control measures are being implemented.

  7. 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.

  8. [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

  9. Urban air pollution and emergency room admissions for respiratory symptoms: a case-crossover study in Palermo, Italy

    OpenAIRE

    Calamusa Giuseppe; Vultaggio Marcello; Cerame Giuseppe; Cusimano Rosanna; Tramuto Fabio; Maida Carmelo M; Vitale Francesco

    2011-01-01

    Abstract Background Air pollution from vehicular traffic has been associated with respiratory diseases. In Palermo, the largest metropolitan area in Sicily, urban air pollution is mainly addressed to traffic-related pollution because of lack of industrial settlements, and the presence of a temperate climate that contribute to the limited use of domestic heating plants. This study aimed to investigate the association between traffic-related air pollution and emergency room admissions for acute...

  10. Effects of volatile substance abuse on the respiratory system in adolescents

    OpenAIRE

    Büker Halime SC; Demir Esen; Yüncü Zeki; Gülen Figen; Midyat Levent; Tanaç Remziye

    2011-01-01

    Abstract Aim Inhalant abuse is a prevalent and often overlooked form of substance abuse in adolescents. Chronic inhalant abuse can damage respiratory, cardiac, renal, hepatic, and neurologic systems. This study aims to determine the physiologic effects of inhaling solvents on the respiratory functions. Methods The general health status of the subjects was assessed by history taking, physical examination and a questionnaire which was designed to show the severity of respiratory symptoms. Spiro...

  11. An overview of chronic vaginal atrophy and options for symptom management.

    Science.gov (United States)

    Woods, Nancy Fugate

    2012-12-01

    During the menopausal transition and after menopause, up to 45 percent of women will develop vaginal atrophy as a consequence of decreased levels of circulating estrogen. Symptoms include vaginal dryness, itching, soreness, bleeding, increased susceptibility to infection and pain with sexual intercourse. Treatments are often underused because of patient and clinician lack of knowledge of available treatments, embarrassment about initiating a discussion of symptoms and reluctance to initiate hormonal therapy. Methods of symptom management include self-care with over-the-counter agents and prescription treatment with various forms of localized estrogen. Clinicians should consider each woman's unique situation and health history before recommending a management strategy.

  12. Effects of the Intelligent-Turtle Massage on the Physical Symptoms and Immune Functions in Patients with Chronic Fatigue Syndrome

    Institute of Scientific and Technical Information of China (English)

    WANG Ji-hong; CHAI Tie-qu; LIN Guo-hua; LUO Lin

    2009-01-01

    To evaluate the effects of the intelligent-turtle massage on the physical symptoms and immune functions in patients with chronic fatigue syndrome (CFS). Methods: 182 cases of CFS were randomly divided into an experimental group of 91 cases treated by the intelligent-turtle massage,and a control group of 91 cases treated with the conventional massage method. After 2 courses of treatment,the therapeutic effects were statistically analyzed with the accumulated score for the improved clinical symptoms; and the changes of IgA,IgM and IgG were compared in 96 cases. Results: There was a significant difference between the two groups in the accumulated scores for improvement of the symptoms (P<0.05). A remarkable difference was found in the therapeutic effect. And there was a significant difference in the IgA,IgM and IgG levels between the two groups (P<0.05). Conclusion: The intelligent-turtle massage is an effective therapy for relieving the physical symptoms of CFS,and it may show certain effects on the immune functions.

  13. Intermittent Oxygen Inhalation with Proper Frequency Improves Overall Health Conditions and Alleviates Symptoms in a Population at High Risk of Chronic Mountain Sickness with Severe Symptoms

    Institute of Scientific and Technical Information of China (English)

    Bin Feng; Wei-Hao Xu; Yu-Qi Gao; Fu-Yu Liu; Peng Li; Shan-Jun Zheng; Lu-Yue Gai

    2016-01-01

    Background:Oxygen inhalation therapy is essential for the treatment of patients with chronic mountain sickness (CMS),but the efficacy of oxygen inhalation for populations at high risk of CMS remains unknown.This research investigated whether oxygen inhalation therapy benefits populations at high risk of CMS.Methods:A total of 296 local residents living at an altitude of 3658 m were included;of which these were 25 diagnosed cases of CMS,8 cases dropped out of the study,and 263 cases were included in the analysis.The subjects were divided into high-risk (180 ≤ hemoglobin (Hb) <210 g/L,n =161) and low-risk (Hb <180 g/L,n =102) groups,and the cases in each group were divided into severe symptom (CMS score ≥6) and mild symptom (CMS score 0-5) subgroups.Severe symptomatic population of either high-or low-risk CMS was randomly assigned to no oxygen intake group (A group) or oxygen intake 7 times/week group (D group);mild symptomatic population of either high-or low-risk CMS was randomly assigned to no oxygen intake group (A group),oxygen intake 2 times/week group (B group),and 4 times/week group (C group).The courses for oxygen intake were all 30 days.The CMS symptoms,sleep quality,physiological biomarkers,biochemical markers,etc.,were recorded on the day before oxygen intake,on the 15th and 30th days of oxygen intake,and on the 15th day after terminating oxygen intake therapy.Results:A total of 263 residents were finally included in the analysis.Among these high-altitude residents,CMS symptom scores decreased for oxygen inhalation methods B,C,and D at 15 and 30 days after oxygen intake and 15 days after termination,including dyspnea,palpitation,and headache index,compared to those before oxygen intake (B group:Z =5.604,5.092,5.741;C group:Z =4.155,4.068,4.809;D group:Z =6.021,6.196,5.331,at the 3 time points respectively;all P < 0.05/3 vs.before intake).However,dyspnea/palpitation (A group:Z =5.003,5.428,5.493,both P < 0.05/3 vs.before intake) and headache (A

  14. 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.

  15. Versão em português do Chronic Respiratory Questionnaire: estudo da validade e reprodutibilidade Portuguese-language version of the Chronic Respiratory Questionnaire: a validity and reproducibility study

    Directory of Open Access Journals (Sweden)

    Graciane Laender Moreira

    2009-08-01

    Full Text Available OBJETIVO: Verificar a validade e a reprodutibilidade de uma versão em português do Chronic Respiratory Questionnaire (CRQ em pacientes com DPOC. MÉTODOS: A versão em português do CRQ (fornecida pela Universidade de McMaster, detentora dos direitos do questionário foi aplicada a 50 pacientes portadores de DPOC (32 homens; 70 ± 8 anos; VEF1 = 47 ± 18% predito em dois momentos, com intervalo de uma semana. O CRQ tem quatro domínios (dispneia, fadiga, função emocional e autocontrole e foi aplicado em formato de entrevista. O Saint George's Respiratory Questionnaire (SGRQ, já validado em português, foi utilizado como o critério de validação. A espirometria e o teste da caminhada de seis minutos (TC6 foram realizados para a análise das correlações com os valores do CRQ. RESULTADOS: Não foram observadas diferenças significativas entre a aplicação e a reaplicação do CRQ (p > 0.05 para todos os domínios. O coeficiente de correlação intraclasse entre a aplicação e a reaplicação foi de 0,98; 0,97; 0,98 e 0,95 para os domínios dispneia, fadiga, função emocional e autocontrole, respectivamente. O coeficiente alfa de Cronbach foi 0,91. Os domínios do CRQ se correlacionaram significativamente com os domínios do SGRQ (-0.30 OBJECTIVE: To determine the validity and reproducibility of a Portuguese-language version of the Chronic Respiratory Questionnaire (CRQ in patients with COPD. METHODS: A Portuguese-language version of the CRQ (provided by McMaster University, the holder of the questionnaire copyright was applied to 50 patients with COPD (70 ± 8 years of age; 32 males; FEV1 = 47 ± 18% of predicted on two occasions, one week apart. The CRQ has four domains (dyspnea, fatigue, emotional function, and mastery and was applied as an interviewer-administered instrument. The Saint George's Respiratory Questionnaire (SGRQ, already validated for use in Brazil, was used as the criterion for validation. Spirometry and the six

  16. 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 (...

  17. 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...

  18. Air pollution and respiratory health of children: the PEACE panel study in Hettstedt and Zerbst., Eastern Germany.

    NARCIS (Netherlands)

    Beyer, U.; Franke, K.; Cyrus, J.; Peters, A.; Heinrich, J.; Wichmann, H.E.; Brunekreef, B.

    1998-01-01

    A multicentre study (Pollution Effects on Asthmatic Children in Europe (PEACE) study) investigated the relationship between the daily variation of respiratory health and air pollution in children with chronic respiratory symptoms. Data were collected for 75 children in Hettstedt (polluted) and 63 ch

  19. 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.

  20. Gender differences in the perception of asthma and respiratory symptoms in a population sample of asthma patients in four Brazilian cities

    Directory of Open Access Journals (Sweden)

    Laura Russo Zillmer

    2014-12-01

    Full Text Available OBJECTIVE: To evaluate the impact of asthma, by gender, in a population sample of asthma patients in Brazil. METHODS: We conducted face-to-face interviews with 400 subjects (> 12 years of age included in a national probability telephone sample of asthma patients in the Brazilian state capitals of São Paulo, Rio de Janeiro, Curitiba, and Salvador. Each of those 400 subjects completed a 53-item questionnaire that addressed five asthma domains: symptoms; impact of asthma on quality of life; perception of asthma control; exacerbations; and treatment/medication. RESULTS: Of the 400 patients interviewed, 272 (68% were female. In relation to respiratory symptoms, the proportion of women reporting extremely bothersome symptoms (cough with sputum, tightness in the chest, cough/shortness of breath/tightness in the chest during exercise, nocturnal shortness of breath, and nocturnal cough was greater than was that of men. Daytime symptoms, such as cough, shortness of breath, wheezing, and tightness in the chest, were more common among women than among men. Women also more often reported that their asthma interfered with normal physical exertion, social activities, sleep, and life in general. Regarding the impact of asthma on quality of life, the proportion of subjects who reported that asthma caused them to feel that they had no control over their lives and affected the way that they felt about themselves was also greater among women than among men. CONCLUSIONS: Among women, asthma tends to be more symptomatic, as well as having a more pronounced effect on activities of daily living and on quality of life.

  1. Salivary IgA response and upper respiratory tract infection symptoms during a 21-week competitive season in young soccer players.

    Science.gov (United States)

    Moreira, Alexandre; Mortatti, Arnaldo L; Arruda, Ademir F S; Freitas, Camila G; de Arruda, Miguel; Aoki, Marcelo S

    2014-02-01

    Sports training and competition are significant sources of stress, especially for young athletes. It is well known that physiological and psychological stressors induce neuroendocrine responses that could modulate immune system function. However, to date, little is known about the immune responses of young soccer players during a competitive season. Therefore, this study examined the effects of a 21-week competitive season divided into preseason, competitive season, and detraining on salivary immunoglobulin A (SIgA), upper respiratory tract infection (URTI) symptoms, and salivary cortisol in preadolescent male soccer players. Thirty-four young soccer players agreed to participate, and 26 (12.9 ± 0.2 years) completed the entire study. The investigation period was structured as follows: a 12-week preparatory training phase (preseason training), a 7-week competitive and a 2-week detraining phase. Resting saliva samples were taken to determine cortisol and SIgA responses. The players were required to complete a weekly log during the entire investigation reporting every sign or symptoms consistent with URTI. A significant increase in SIgA secretion rate and a decrease in URTI symptoms were observed after the 2-week detraining period (p cortisol during the study. These results indicate that training and competition demands affect the mucosal immune responses of young athletes. In addition, a short-prophylactic period (2-week detraining period) after a competitive period may attenuate mucosal immunosuppression related to URTI symptoms. Sport coaches should monitor markers of mucosal immune function to minimize illness that ultimately might lead to a decrease in performance.

  2. Notes from the Field: Respiratory Symptoms and Skin Irritation Among Hospital Workers Using a New Disinfection Product - Pennsylvania, 2015.

    Science.gov (United States)

    Hawley, Brie; Casey, Megan L; Cox-Ganser, Jean M; Edwards, Nicole; Fedan, Kathleen B; Cummings, Kristin J

    2016-01-01

    In March 2014, a new disinfection product, consisting of hydrogen peroxide, peroxyacetic acid, and acetic acid, was introduced at a Pennsylvania hospital to aid in the control of health care-associated infections. The product is an Environmental Protection Agency-registered non-bleach sporicide advertised as a one-step cleaner, disinfectant, and deodorizer. According to the manufacturer's safety data sheet, the product requires no personal protective equipment when it is diluted with water by an automated dispenser before use. On January 30, 2015, CDC's National Institute for Occupational Health (NIOSH) received a confidential employee request to conduct a health hazard evaluation at the hospital. The request cited concerns about exposure of hospital environmental services staff members to the product and reported symptoms among persons who had used the product that included eye and nasal problems, asthma-like symptoms, shortness of breath, skin problems, wheeze, chest tightness, and cough. PMID:27100053

  3. An unusual cause of chronic abdominal pain after laparoscopic Roux en Y gastric bypass: Case report of a penetrating fish bone causing adhesions at the biliary-digestive junction resulting in partial obstruction and chronic symptoms

    Directory of Open Access Journals (Sweden)

    Vincent Ochieng

    2016-01-01

    Conclusion: This case highlights the possibility of a missed fish bone perforation causing chronic postprandial abdominal pain and discomfort in a patient with a Roux-en-Y gastric bypass anatomy. Foreign body perforation is a rare cause of abdominal pain after gastric bypass that should be considered when evaluating chronic abdominal pain symptoms after LRYGP.

  4. Absence of back to school peaks in human rhinovirus detections and respiratory symptoms in a cohort of children with asthma.

    Science.gov (United States)

    Stelzer-Braid, Sacha; Tovey, Euan R; Willenborg, Christiana M; Toelle, Brett G; Ampon, Rose; Garden, Frances L; Oliver, Brian G; Strachan, Roxanne; Belessis, Yvonne; Jaffe, Adam; Reddel, Helen K; Crisafulli, Daniel; Marks, Guy B; Rawlinson, William D

    2016-04-01

    Much of what is known about the seasonality of human rhinovirus (hRV) infections has been learned from the study of acute asthma exacerbations presenting to emergency care, including those among children at the start of the school term. Much less is known about the patterns of hRVs in the community. In this study, viruses and day-to-day symptoms of asthma and colds were monitored twice weekly in 67 children with asthma aged 5-12 years, over a 15 month period in Sydney, Australia. Overall hRV was detected in 314/1232 (25.5%) of nasal wash samples and 142/1231 (11.5%) of exhaled breath samples; of these, 231 and 24 respectively were genotyped. HRVs were detected with similar prevalence rate throughout the year, including no peak in hRV prevalence following return to school. No peaks were seen in asthma and cold symptoms using twice-weekly diary records. However, over the same period in the community, there were peaks in asthma emergency visits both at a large local hospital and in state-wide hospitalizations, following both return to school (February) and in late autumn (May) in children of the same age. This study suggests that hRV infections are common throughout the year among children, and differences in virus prevalence alone may not account for peaks in asthma symptoms.

  5. Latent Variable Analysis of Coping, Anxiety/Depression, and Somatic Symptoms in Adolescents with Chronic Pain

    Science.gov (United States)

    Compas, Bruce E.; Boyer, Margaret C.; Stanger, Catherine; Colletti, Richard B.; Thomsen, Alexandra H.; Dufton, Lynette M.; Cole, David A.

    2006-01-01

    Reports of adolescents' coping with recurrent pain, symptoms of anxiety/depression, and somatic complaints were obtained from a sample of 164 adolescents with recurrent abdominal pain and their parents. Confirmatory factor analysis revealed that coping consisted of 3 nonorthogonal factors: Primary Control Engagement Coping (problem solving,…

  6. Chronic post-concussion neurocognitive deficits. II. Relationship with persistent symptoms

    Directory of Open Access Journals (Sweden)

    Jun eMaruta

    2016-02-01

    Full Text Available Individuals who sustain a concussion may continue to experience problems long after their injury. However, it has been postulated in the literature that the relationship between a concussive injury and persistent complaints attributed to it is mediated largely by the development of symptoms associated with posttraumatic stress disorder and depression. We sought to characterize cognitive deficits of adult patients who had persistent symptoms after a concussion and determine whether the original injury retains associations with these deficits after accounting for the developed symptoms that overlap with posttraumatic stress disorder and depression. We compared the results of neurocognitive testing from 33 patients of both genders aged 18-55 at three months to five years post-injury with those from 140 control subjects. Statistical comparisons revealed that patients generally produced accurate responses on reaction time-based tests, but with reduced efficiency. On visual tracking, patients increased gaze position error variability following an attention demanding task, an effect that may reflect greater fatigability. When neurocognitive performance was examined in the context of demographic- and symptom-related variables, the original injury retained associations with reduced performance at a statistically significant level. For some patients, reduced cognitive efficiency and fatigability may represent key elements of interference when interacting with the environment, leading to varied paths of recovery after a concussion. Poor recovery may be better understood when these deficits are taken into consideration.

  7. Impact of chronic obstructive pulmonary disease on survival and symptoms of severe aortic valve stenosis

    DEFF Research Database (Denmark)

    Poulsen, Mikael K; Dahl, Jordi S; Kjeldsen, Bo J;

    2015-01-01

    severe comorbidities, including chronic obstructive pulmonary disease (COPD). MATERIALS AND METHODS: Since the beginning of our TAVI program in March 2008, data on all 131 TAVI patients were prospectively and consecutively collected in this registry with complete follow-up. COPD was present in 37...

  8. Urinary symptoms and Micromotions of bladder wall in chronic pelvic pain (CPP)

    NARCIS (Netherlands)

    P. van Os-Bossagh (Pooran)

    1998-01-01

    textabstractChronic lower abdominal pain of unknown origin in women has intrigued many investigators. It is the gynecologist in particular to whom patients with this syndrome address for relief. AB a matter of fact not less than approximately 10% of patients visiting gynaecologists do so in cOlmecti

  9. Treatment of respiratory failure in COPD

    Directory of Open Access Journals (Sweden)

    Stephan Budweiser

    2008-12-01

    Full Text Available Stephan Budweiser1, Rudolf A Jörres2, Michael Pfeifer1,31Center for Pneumology, Hospital Donaustauf, Donaustauf, Germany; 2Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Ludwig-Maximilians-University, Munich, Germany; 3Department of Internal Medicine II, Division of Respirology, University of Regensburg, Regensburg, GermanyAbstract: Patients with advanced COPD and acute or chronic respiratory failure are at high risk for death. Beyond pharmacological treatment, supplemental oxygen and mechanical ventilation are major treatment options. This review describes the physiological concepts underlying respiratory failure and its therapy, as well as important treatment outcomes. The rationale for the controlled supply of oxygen in acute hypoxic respiratory failure is undisputed. There is also a clear survival benefit from long-term oxygen therapy in patients with chronic hypoxia, while in mild, nocturnal, or exercise-induced hypoxemia such long-term benefits appear questionable. Furthermore, much evidence supports the use of non-invasive positive pressure ventilation in acute hypercapnic respiratory failure. It application reduces intubation and mortality rates, and the duration of intensive care unit or hospital stays, particularly in the presence of mild to moderate respiratory acidosis. COPD with chronic hypercapnic respiratory failure became a major indication for domiciliary mechanical ventilation, based on pathophysiological reasoning and on data regarding symptoms and quality of life. Still, however, its relevance for long-term survival has to be substantiated in prospective controlled studies. Such studies might preferentially recruit patients with repeated hypercapnic decompensation or a high risk for death, while ensuring effective ventilation and the patients’ adherence to therapy.Keywords: respiratory failure, COPD, mechanical ventilation, non-invasive ventilation long-term oxygen therapy, chronic

  10. Recurrent short sleep, chronic insomnia symptoms and salivary cortisol: A 10-year follow-up in the Whitehall II study

    Science.gov (United States)

    Abell, Jessica G.; Shipley, Martin J.; Ferrie, Jane E.; Kivimäki, Mika; Kumari, Meena

    2016-01-01

    Although an association between both sleep duration and disturbance with salivary cortisol has been suggested, little is known about the long term effects of poor quality sleep on diurnal cortisol rhythm. The aim of this study was to examine the association of poor quality sleep, categorised as recurrent short sleep duration and chronic insomnia symptoms, with the diurnal release of cortisol. We examined this in 3314 participants from an occupational cohort, originally recruited in 1985–1989. Salivary cortisol was measured in 2007–2009 and six saliva samples were collected: (1) waking, (2) waking + 0.5 h, (3) +2.5 h, (4) +8 h, (5) +12 h and (6) bedtime, for assessment of the cortisol awakening response and the diurnal slope in cortisol secretion. Participants with the first saliva sample collected within 15 min of waking and not on steroid medication were examined. Short sleep duration (≤5 h) and insomnia symptoms (Jenkins scale, highest quartile) were measured in 1997–1999, 2003–2004 and 2007–2009. Recurrent short sleep was associated with a flatter diurnal cortisol pattern. A steeper morning rise in cortisol was observed among those reporting chronic insomnia symptoms at three time points and among those reporting short sleep twice, compared to those who never reported sleep problems. Participants reporting short sleep on three occasions had higher levels of cortisol later in the day, compared to those never reporting short sleep, indicated by a positive interaction with hours since waking (β = 0.02 (95% CI: 0.01, 0.03)). We conclude that recurrent sleep problems are associated with adverse salivary cortisol patterns throughout the day. PMID:26963375

  11. A randomized, double-blind, placebo-controlled pilot study of a probiotic in emotional symptoms of chronic fatigue syndrome

    Directory of Open Access Journals (Sweden)

    Rao A Venket

    2009-03-01

    Full Text Available Abstract Chronic fatigue syndrome (CFS is complex illness of unknown etiology. Among the broad range of symptoms, many patients report disturbances in the emotional realm, the most frequent of which is anxiety. Research shows that patients with CFS and other so-called functional somatic disorders have alterations in the intestinal microbial flora. Emerging studies have suggested that pathogenic and non-pathogenic gut bacteria might influence mood-related symptoms and even behavior in animals and humans. In this pilot study, 39 CFS patients were randomized to receive either 24 billion colony forming units of Lactobacillus casei strain Shirota (LcS or a placebo daily for two months. Patients provided stool samples and completed the Beck Depression and Beck Anxiety Inventories before and after the intervention. We found a significant rise in both Lactobacillus and Bifidobacteria in those taking the LcS, and there was also a significant decrease in anxiety symptoms among those taking the probiotic vs controls (p = 0.01. These results lend further support to the presence of a gut-brain interface, one that may be mediated by microbes that reside or pass through the intestinal tract.

  12. Goal Setting and Treatment Adherence among Patients with Chronic Illness and Depressive Symptoms: Applying a Patient-Centered Approach

    Science.gov (United States)

    Houston, Eric; Tatum, Alexander K.; Guy, Arryn; Mikrut, Cassandra; Yoder, Wren

    2016-01-01

    Objective: Poor treatment adherence is a major problem among individuals with chronic illness. Research indicates that adherence is worsened when accompanied by depressive symptoms. In this preliminary study, we aimed to describe how a patient-centered approach could be employed to aid patients with depressive symptoms in following their treatment regimens. Methods: The sample consisted of 14 patients undergoing antiretroviral therapy (ART) for HIV who reported clinically-significant depressive symptoms. Participant ratings of 23 treatment-related statements were examined using two assessment and analytic techniques. Interviews were conducted with participants to determine their views of information based on the technique. Results: Results indicate that while participants with optimal adherence focused on views of treatment associated with side effects to a greater extent than participants with poor adherence, they tended to relate these side effects to sources of intrinsic motivation. Conclusion: The study provides examples of how practitioners could employ the assessment techniques outlined to better understand how patients think about treatment and aid them in effectively framing their health-related goals. PMID:26755463

  13. Effects of Air Pollution and the Introduction of the London Low Emission Zone on the Prevalence of Respiratory and Allergic Symptoms in Schoolchildren in East London: A Sequential Cross-Sectional Study.

    Directory of Open Access Journals (Sweden)

    Helen E Wood

    Full Text Available The adverse effects of traffic-related air pollution on children's respiratory health have been widely reported, but few studies have evaluated the impact of traffic-control policies designed to reduce urban air pollution. We assessed associations between traffic-related air pollutants and respiratory/allergic symptoms amongst 8-9 year-old schoolchildren living within the London Low Emission Zone (LEZ. Information on respiratory/allergic symptoms was obtained using a parent-completed questionnaire and linked to modelled annual air pollutant concentrations based on the residential address of each child, using a multivariable mixed effects logistic regression analysis. Exposure to traffic-related air pollutants was associated with current rhinitis: NOx (OR 1.01, 95% CI 1.00-1.02, NO2 (1.03, 1.00-1.06, PM10 (1.16, 1.04-1.28 and PM2.5 (1.38, 1.08-1.78, all per μg/m3 of pollutant, but not with other respiratory/allergic symptoms. The LEZ did not reduce ambient air pollution levels, or affect the prevalence of respiratory/allergic symptoms over the period studied. These data confirm the previous association between traffic-related air pollutant exposures and symptoms of current rhinitis. Importantly, the London LEZ has not significantly improved air quality within the city, or the respiratory health of the resident population in its first three years of operation. This highlights the need for more robust measures to reduce traffic emissions.

  14. 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

  15. 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.

  16. Effects of topical administration of beclomethazone dipropionate on the symptoms of chronic rhinitis

    OpenAIRE

    Ursulović Dejan D.; Janošević Ljiljana B.; Janošević Slobodanka B.; Đukić Vojko

    2003-01-01

    The aim of this study was to evaluate the effect of topical administration of corticosteroid beclomethasone dipropionate on common nasal symptoms in moderate allergic and non-allergic hyperreactive eosinophilic rhinitis, and in allergic and non-allergic hyperreactive eosinophilic rhinitis associated with bilateral moderate nasal polyposis. The study was prospective and controlled. During the study 106 patients were examined, out of whom 66 were treated, while 40 had no therapy. Beclomethasone...

  17. Symptoms and side effects in chronic non-cancer pain patients

    DEFF Research Database (Denmark)

    Olsen, T S; Jonsson, T; Højsted, J;

    2015-01-01

    pain of non-cancer origin for more than 6 months, were asked to fill in two questionnaires: QSSE-41 or QSSE-33 and SF-36. The first part of the study (QSSE-41) included an age- and sex-matched control group. RESULTS: A total of 67 patients were included in QSSE-41 and 60 patients in QSSE-33. In QSSE-41......, the mean number of symptoms reported by the patient group (12.3) was significantly higher than those reported by the controls (6.8) (P effects caused by analgesics, and out of those 61.3% were reported as acceptable and 38.......7% as unacceptable side effects. In the QSSE-33, the mean number of symptoms reported by the patient group was 13.6. Out of the total number of symptoms, 46.3% were reported to be side effects caused by analgesics, and out of those 56.4% were reported as acceptable and 43.6% as unacceptable side effects. CONCLUSIONS...

  18. Effectiveness of alcohol-based hand disinfectants in a public administration: Impact on health and work performance related to acute respiratory symptoms and diarrhoea

    Directory of Open Access Journals (Sweden)

    Hübner Nils-Olaf

    2010-08-01

    Full Text Available Abstract Background The economical impact of absenteeism and reduced productivity due to acute infectious respiratory and gastrointestinal disease is normally not in the focus of surveillance systems and may therefore be underestimated. However, large community studies in Europe and USA have shown that communicable diseases have a great impact on morbidity and lead to millions of lost days at work, school and university each year. Hand disinfection is acknowledged as key element for infection control, but its effect in open, work place settings is unclear. Methods Our study involved a prospective, controlled, intervention-control group design to assess the epidemiological and economical impact of alcohol-based hand disinfectants use at work place. Volunteers in public administrations in the municipality of the city of Greifswald were randomized in two groups. Participants in the intervention group were provided with alcoholic hand disinfection, the control group was unchanged. Respiratory and gastrointestinal symptoms and days of work were recorded based on a monthly questionnaire over one year. On the whole, 1230 person months were evaluated. Results Hand disinfection reduced the number of episodes of illness for the majority of the registered symptoms. This effect became statistically significant for common cold (OR = 0.35 [0.17 - 0.71], p = 0.003, fever (OR = 0.38 [0.14-0.99], p = 0.035 and coughing (OR = 0.45 [0.22 - 0.91], p = 0.02. Participants in the intervention group reported less days ill for most symptoms assessed, e.g. colds (2.07 vs. 2.78%, p = 0.008, fever (0.25 vs. 0.31%, p = 0.037 and cough (1.85 vs. 2.00%, p = 0.024. For diarrhoea, the odds ratio for being absent became statistically significant too (0.11 (CI 0.01 - 0.93. Conclusion Hand disinfection can easily be introduced and maintained outside clinical settings as part of the daily hand hygiene. Therefore it appears as an interesting, cost-efficient method within the scope

  19. Stressful Life Events, Chronic Difficulties, and the Symptoms of Clinical Depression

    OpenAIRE

    Muscatell, Keely A.; Slavich, George M.; Monroe, Scott M.; Gotlib, Ian H.

    2009-01-01

    Major life events and chronic difficulties have been found to be associated with the onset of depression. Little is known, however, about how exposure to such stressors is related to the clinical presentation of this disorder. We addressed this issue by administering an interview-based measure of life stress, the Beck Depression Inventory, and the Global Assessment of Functioning scale to 100 adults diagnosed with major depressive disorder. Participants who experienced a preonset severe life ...

  20. Vitamin D Supplements Improve Urticaria Symptoms and Quality of Life in Chronic Spontaneous Urticaria Patients

    OpenAIRE

    Boonpiyathad, Tadech; Pradubpongsa, Panitan; Sangasapaviriya, Atik

    2014-01-01

    Vitamin D plays an important role in the immune system; decreased serum vitamin D concentrations have been linked to dysregulated immune function. Low vitamin D status is probably associated with chronic spontaneous urticaria (CSU). We evaluated the prevalence of low vitamin D status, and the clinical response and quality of life following vitamin D supplementation, in a prospective case-control study with 60 CSU patients and 40 healthy individuals. Serum 25-hydroxy vitamin D (25(OH)D) concen...

  1. Neuromuscular strain as a contributor to cognitive and other symptoms in chronic fatigue syndrome: hypothesis and conceptual model.

    Science.gov (United States)

    Rowe, Peter C; Fontaine, Kevin R; Violand, Richard L

    2013-01-01

    Individuals with chronic fatigue syndrome (CFS) have heightened sensitivity and increased symptoms following various physiologic challenges, such as orthostatic stress, physical exercise, and cognitive challenges. Similar heightened sensitivity to the same stressors in fibromyalgia (FM) has led investigators to propose that these findings reflect a state of central sensitivity. A large body of evidence supports the concept of central sensitivity in FM. A more modest literature provides partial support for this model in CFS, particularly with regard to pain. Nonetheless, fatigue and cognitive dysfunction have not been explained by the central sensitivity data thus far. Peripheral factors have attracted attention recently as contributors to central sensitivity. Work by Brieg, Sunderland, and others has emphasized the ability of the nervous system to undergo accommodative changes in length in response to the range of limb and trunk movements carried out during daily activity. If that ability to elongate is impaired-due to movement restrictions in tissues adjacent to nerves, or due to swelling or adhesions within the nerve itself-the result is an increase in mechanical tension within the nerve. This adverse neural tension, also termed neurodynamic dysfunction, is thought to contribute to pain and other symptoms through a variety of mechanisms. These include mechanical sensitization and altered nociceptive signaling, altered proprioception, adverse patterns of muscle recruitment and force of muscle contraction, reduced intra-neural blood flow, and release of inflammatory neuropeptides. Because it is not possible to differentiate completely between adverse neural tension and strain in muscles, fascia, and other soft tissues, we use the more general term "neuromuscular strain." In our clinical work, we have found that neuromuscular restrictions are common in CFS, and that many symptoms of CFS can be reproduced by selectively adding neuromuscular strain during the

  2. 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.

  3. Neuronal injury in the motor cortex after chronic stroke and lower limb motor impairment:a voxel-based lesion symptom mapping study

    Institute of Scientific and Technical Information of China (English)

    Alexandria M. Reynolds; Denise M. Peters; Jennifer M. C. Vendemia; Lenwood P. Smith; Raymond C. Sweet; Gordon C. Baylis; Debra Krotish; Stacy L Fritz

    2014-01-01

    Many studies have examined motor impairments using voxel-based lesion symptom mapping, but few are reported regarding the corresponding relationship between cerebral cortex injury and lower limb motor impairment analyzed using this technique. This study correlated neuro-nal injury in the cerebral cortex of 16 patients with chronic stroke based on a voxel-based lesion symptom mapping analysis. Neuronal injury in the corona radiata, caudate nucleus and putamen of patients with chronic stroke could predict walking speed. The behavioral measure scores were consistent with motor deifcits expected after damage to the cortical motor system due to stroke. These ifndings suggest that voxel-based lesion symptom mapping may provide a more accurate prognosis of motor recovery from chronic stroke according to neuronal injury in cerebral motor cortex.

  4. Public beliefs on antibiotics and symptoms of respiratory tract infections among rural and urban population in Poland: a questionnaire study.

    Directory of Open Access Journals (Sweden)

    Maciek Godycki-Cwirko

    Full Text Available General public views and expectations around the use of antibiotics can influence general practitioners' antibiotic prescribing decisions. We set out to describe the knowledge, attitudes and beliefs about the use of antibiotics for respiratory tract infections in adults in Poland, and explore differences according to where people live in an urban-rural continuum.Face to face survey among a stratified random sample of adults from the general population.1,210 adults completed the questionnaire (87% response rate; 44.3% were rural; 57.9% were women. 49.4% of rural respondents and 44.4% of urban respondents had used an antibiotic in the last 2 years. Rural participants were less likely to agree with the statement "usually I know when I need an antibiotic," (53.5% vs. 61.3% respectively; p = 0.015 and reported that they would consult with a physician for a cough with yellow/green phlegm (69.2% vs. 74.9% respectively; p = 0.004, and were more likely to state that they would leave the decision about antibiotic prescribing to their doctor (87.5% vs. 85.6% respectively; p = 0.026. However, rural participants were more likely to believe that antibiotics accelerate recovery from sore throat (45.7% vs. 37.1% respectively; p = 0.017. Use of antibiotic in the last 2 years, level of education, number of children and awareness of the problem of developing antimicrobial resistance predicted accurate knowledge about antibiotic effectiveness.There were no major differences in beliefs about antibiotics between urban and rural responders, although rural responders were slightly less confident in their knowledge about antibiotics and self-reported greater use of antibiotics. Despite differences in the level of education between rural and urban responders, there were no significant differences in their knowledge about antibiotic effectiveness.

  5. Doxapram hydrochloride in the treatment of acute exacerbation of chronic respiratory failure. A patient with four episodes treated without use of a respirator.

    Science.gov (United States)

    Ohi, M; Nakashima, M; Heki, S; Kato, M; Sagawa, Y

    1978-10-01

    A 51-year-old woman with chronic respiratory failure (status after tuberculosis) was given an infusion of doxapram hydrochloride (1 to 2 mg/kg of body weight per hour) for four episodes of acute exacerbation of her condition. Treatment with the drug prevented worsening of hypercapnia in the four episodes, when administration of 24 percent oxygen had occasioned rises in the arterial carbon dioxide tension of 23, 10, 9, and 7 mm Hg.

  6. 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...

  7. Deployment-related Respiratory Issues.

    Science.gov (United States)

    Morris, Michael J; Rawlins, Frederic A; Forbes, Damon A; Skabelund, Andrew J; Lucero, Pedro F

    2016-01-01

    Military deployment to Southwest Asia since 2003 in support of Operations Enduring Freedom/Iraqi Freedom/New Dawn has presented unique challenges from a pulmonary perspective. Various airborne hazards in the deployed environment include suspended geologic dusts, burn pit smoke, vehicle exhaust emissions, industrial air pollution, and isolated exposure incidents. These exposures may give rise to both acute respiratory symptoms and in some instances development of chronic lung disease. While increased respiratory symptoms during deployment are well documented, there is limited data on whether inhalation of airborne particulate matter is causally related to an increase in either common or unique pulmonary diseases. While disease processes such as acute eosinophilic pneumonia and exacerbation of preexisting asthma have been adequately documented, there is significant controversy surrounding the potential effects of deployment exposures and development of rare pulmonary disorders such as constrictive bronchiolitis. The role of smoking and related disorders has yet to be defined. This article presents the current evidence for deployment-related respiratory symptoms and ongoing Department of Defense studies. Further, it also provides general recommendations for evaluating pulmonary health in the deployed military population.

  8. Personality Traits and Mental Symptoms are Associated with Impact of Chronic Obstructive Pulmonary Disease on Patients' Daily life

    DEFF Research Database (Denmark)

    Topp, Marie; Vestbo, Jørgen; Mortensen, Erik Lykke

    2016-01-01

    Previous research has shown that personality traits are associated with self-reported health status in the general population. COPD Assessment Test (CAT) is increasingly used to assess health status such as the impact of chronic obstructive pulmonary disease (COPD) on patients' daily life......, but knowledge about the influence of personality traits on CAT score is lacking. The aim of this study was to examine the influence of Big Five personality traits on CAT score and the relation between personality traits and mental symptoms with respect to their influence on CAT score. A sample of 168 patients...... diagnosed with COPD was consecutively recruited in a secondary care outpatient clinic. All participants completed CAT, NEO Five-Factor Inventory, and Hospital Depression and Anxiety Scale. Multiple linear regression analysis was used to explore the association between personality traits and CAT scores...

  9. 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.

  10. Somatic symptoms beyond those generally associated with a whiplash injury are increased in self-reported chronic whiplash. A population-based cross sectional study: the Hordaland Health Study (HUSK

    Directory of Open Access Journals (Sweden)

    Myrtveit Solbjørg

    2012-08-01

    Full Text Available Abstract Background Chronic whiplash leads to considerable patient suffering and substantial societal costs. There are two competing hypothesis on the etiology of chronic whiplash. The traditional organic hypothesis considers chronic whiplash and related symptoms a result of a specific injury. In opposition is the hypothesis that chronic whiplash is a functional somatic syndrome, and related symptoms a result of society-induced expectations and amplification of symptoms. According to both hypotheses, patients reporting chronic whiplash are expected to have more neck pain, headache and symptoms of anxiety and depression than the general population. Increased prevalence of somatic symptoms beyond those directly related to a whiplash neck injury is less investigated. The aim of this study was to test an implication derived from the functional hypothesis: Is the prevalence of somatic symptoms as seen in somatization disorder, beyond symptoms related to a whiplash neck injury, increased in individuals self-reporting chronic whiplash? We further aimed to explore recall bias by comparing the symptom profile displayed by individuals self-reporting chronic whiplash to that among those self-reporting a non-functional injury: fractures of the hand or wrist. We explored symptom load, etiologic origin could not be investigated in this study. Methods Data from the Norwegian population-based “Hordaland Health Study” (HUSK, 1997–99; N = 13,986 was employed. Chronic whiplash was self-reported by 403 individuals and fractures by 1,746. Somatization tendency was measured using a list of 17 somatic symptoms arising from different body parts and organ systems, derived from the research criteria for somatization disorder (ICD-10, F45. Results Chronic whiplash was associated with an increased level of all 17 somatic symptoms investigated (p Conclusions The increased prevalence of somatic symptoms beyond symptoms expected according to the organic injury model

  11. Contributions of societal and geographical environments to "chronic Lyme disease": the psychopathogenesis and aporology of a new "medically unexplained symptoms" syndrome.

    Science.gov (United States)

    Sigal, Leonard H; Hassett, Afton L

    2002-08-01

    Lyme disease is a relatively well-described infectious disease with multisystem manifestations. Because of confusion over conflicting reports, anxiety related to vulnerability to disease, and sensationalized and inaccurate lay media coverage, a new syndrome, "chronic Lyme disease," has become established. Chronic Lyme disease is the most recent in a continuing series of "medically unexplained symptoms" syndromes. These syndromes, such as fibromyalgia, chronic fatigue syndrome, and multiple chemical sensitivity, meet the need for a societally and morally acceptable explanation for ill-defined symptoms in the absence of objective physical and laboratory findings. We describe factors involved in the psychopathogenesis of chronic Lyme disease and focus on the confusion and insecurity these patients feel, which gives rise to an inability to adequately formulate and articulate their health concerns and to deal adequately with their medical needs, a state of disorganization termed aporia.

  12. Inspection of the Spirometric Parameters and the Frequency of Respiratory Symptoms in Soldering Workers of a Factory Producing Electronic Appliances

    Directory of Open Access Journals (Sweden)

    E Safavi

    2005-07-01

    Full Text Available Introduction: Regarding the numerous problems of solderers in electronic industries because of their exposure to Acids, bases and fumes of soldering ,a study was carried out on107 solderers and administrative personels of a factory producing electronic appliances in Tehran to inspect the long term effects of soldering on lung functions Inspection. Methods: At first ,47 solderers and 66 controls (totally 107 persons were selected randomly. All the solderers were working in the manual soldering section and used the soldering wire made of an alloy (composed of plumbum, Stannum and special oil of soldering called flux . The persons controls worked in the administrative sections of the same factory and for the same hours as the solderers , but they did not have any soldering experience. After they filled the standard respiratory questionnaire , spirometry was done at least 3 times on each of them under the same conditions and according to the ACT criteria (No smokers included in the study Results:The spirometry parameters of the two groups were compared . There was a significant difference in the average FEF 25 : 75% (P=0.03.Also ,there was a significant difference in the average FEV1/FVC P=0.026 and PEFR (P=0.04between two groups .After controling the altering age factor . ameaningful relation between the years of work in soldering section and decrease in the spirometry parameters related to FED 25-75% and FEV1/FVC was seem . Also . the frequency of the signs of nasal and eyes initation in the solderer group was more than the other group (p=0.007 Cough and Asthma related to ork had no meaningful difference in the two groups . Conclsion :It seem that in the above study , soldering is a factor decreasing the spirometry parameters with a blocking pattern , especilly in smal airways . This study was done in the direction of the former studies done in other countries and emphasizes on the need for necessary preventive action in this profession , uch as

  13. Symptoms and quality of life in patients with chronic obstructive pulmonary disease treated with aclidinium in a real-life setting

    OpenAIRE

    Telg, Gunilla; Lange, Peter; Skavlan Godtfredsen, Nina; Olejnicka, Beata; Paradis, Bo-Anders; Curiac, Dan; Humerfelt, Sjur; Nordahl Christensen, Helene; Bitsch, Magnus Alexander; Wreford Andersen, Elisabeth; Bjermer, Leif

    2016-01-01

    Introduction: Chronic obstructive pulmonary disease (COPD) is a progressive disease with symptoms that can have a major impact on patients’ physical health. The aim of this study was to evaluate quality of life (QoL), symptom severity and dyspnoea in COPD patients treated with aclidinium up to 24 weeks.Methods: In this prospective non-interventional multicentre study (198 centres in Sweden, Denmark, and Norway), COPD patients (age ≥40 years) who started treatment with aclidinium (initial ther...

  14. Symptoms and quality of life in patients with chronic obstructive pulmonary disease treated with aclidinium in a real-life setting

    OpenAIRE

    Peter Lange; Nina Skavlan Godtfredsen; Beata Olejnicka; Bo-Anders Paradis; Dan Curiac; Sjur Humerfelt; Gunilla Telg; Helene Nordahl Christensen; Magnus Alexander Bitsch; Elisabeth Wreford Andersen; Leif Bjermer

    2016-01-01

    Introduction: Chronic obstructive pulmonary disease (COPD) is a progressive disease with symptoms that can have a major impact on patients’ physical health. The aim of this study was to evaluate quality of life (QoL), symptom severity and dyspnoea in COPD patients treated with aclidinium up to 24 weeks. Methods: In this prospective non-interventional multicentre study (198 centres in Sweden, Denmark, and Norway), COPD patients (age ≥40 years) who started treatment with aclidinium (initial the...

  15. Comparing the Efficacy of Eye Movement Desensitization and Reprocessing Therapy with Prolonged Exposure Therapy on the Trauma impact symptoms in Veterans Suffering from Chronic PTSD

    OpenAIRE

    A Maredpour; F. Naderi; M Mehrabizadeh-Honarmand

    2013-01-01

    Abstract Background and aim: Post-traumatic stress disorder is considered as set of symptoms developed afterward an individual witness, hear or involved. The current research was purposed to compare the efficacy of eye movement desensitization and reprocessing therapy with prolonged exposure therapy on the trauma impact symptoms in veterans suffering from chronic PTSD. Methods: in this clinical trail research randomly sampled 48 veterans diagnosed with PTSD who had psychiatric rec...

  16. 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

  17. Lesion correlates of patholinguistic profiles in chronic aphasia: comparisons of syndrome-, modality- and symptom-level assessment.

    Science.gov (United States)

    Henseler, Ilona; Regenbrecht, Frank; Obrig, Hellmuth

    2014-03-01

    One way to investigate the neuronal underpinnings of language competence is to correlate patholinguistic profiles of aphasic patients to corresponding lesion sites. Constituting the beginnings of aphasiology and neurolinguistics over a century ago, this approach has been revived and refined in the past decade by statistical approaches mapping continuous variables (providing metrics that are not simply categorical) on voxel-wise lesion information (voxel-based lesion-symptom mapping). Here we investigate whether and how voxel-based lesion-symptom mapping allows us to delineate specific lesion patterns for differentially fine-grained clinical classifications. The latter encompass 'classical' syndrome-based approaches (e.g. Broca's aphasia), more symptom-oriented descriptions (e.g. agrammatism) and further refinement to linguistic sub-functions (e.g. lexico-semantic deficits for inanimate versus animate items). From a large database of patients treated for aphasia of different aetiologies (n = 1167) a carefully selected group of 102 first ever ischaemic stroke patients with chronic aphasia (∅ 12 months) were included in a VLSM analysis. Specifically, we investigated how performance in the Aachen Aphasia Test-the standard clinical test battery for chronic aphasia in German-relates to distinct brain lesions. The Aachen Aphasia Test evaluates aphasia on different levels: a non-parametric discriminant procedure yields probabilities for the allocation to one of the four 'standard' syndromes (Broca, Wernicke, global and amnestic aphasia), whereas standardized subtests target linguistic modalities (e.g. repetition), or even more specific symptoms (e.g. phoneme repetition). Because some subtests of the Aachen Aphasia Test (e.g. for the linguistic level of lexico-semantics) rely on rather coarse and heterogeneous test items we complemented the analysis with a number of more detailed clinically used tests in selected mostly mildly affected subgroups of patients. Our results

  18. A Systematic Review of the Efficacy of Centella asiatica for Improvement of the Signs and Symptoms of Chronic Venous Insufficiency

    Directory of Open Access Journals (Sweden)

    Nyuk Jet Chong

    2013-01-01

    Full Text Available We aimed to assess the efficacy of Centella asiatica for improvement of the signs and symptoms of chronic venous insufficiency (CVI. We searched 13 electronic databases including the Cochrane Central Register of Controlled Trials for randomised controlled trials assessing the efficacy of Centella asiatica for CVI. Two review authors independently selected studies, assessed the risks of bias of included studies and extracted data. The treatment effects of similar studies were pooled whenever appropriate. Eight studies met the inclusion criteria. The pooling of data of similar studies showed that Centella asiatica significantly improved microcirculatory parameters such as transcutaneous partial pressure of CO2 and O2, rate of ankle swelling and venoarteriolar response. Three out of the eight studies did not provide quantitative data. However, these studies reported that patients treated with Centella asiatica showed significant improvement in CVI signs such as leg heaviness, pain and oedema. Our results show that Centella asiatica may be beneficial for improving signs and symptoms of CVI but this conclusion needs to be interpreted with caution as most of the studies were characterised by inadequate reporting and thus had unclear risks of bias, which may threaten the validity of the conclusions.

  19. Borrelia burgdorferi DNA in the urine of treated patients with chronic Lyme disease symptoms. A PCR study of 97 cases.

    Science.gov (United States)

    Bayer, M E; Zhang, L; Bayer, M H

    1996-01-01

    The presence of Borrelia burgdorferi DNA was established by PCR from urine samples of 97 patients clinically diagnosed as presenting with symptoms of chronic Lyme disease. All patients had shown erythema chronica migrans following a deer tick bite. Most of the patients had been antibiotic-treated for extended periods of time. We used three sets of primer pairs with DNA sequences for the gene coding of outer surface protein A (OspA) and of a genomic sequence of B. burgdorferi to study samples of physician-referred patients from the mideastern USA. Controls from 62 healthy volunteers of the same geographic areas were routinely carried through the procedures in parallel with patients' samples. Of the 97 patients, 72 (74.2%) were found with positive PCR and the rest with negative PCR. The 62 healthy volunteers were PCR negative. It is proposed that a sizeable group of patients diagnosed on clinical grounds as having chronic Lyme disease may still excrete Borrelia DNA, and may do so in spite of intensive antibiotic treatment.

  20. Patients with chronic headache tend to have more psychological symptoms than those with sporadic episodes of pain

    Directory of Open Access Journals (Sweden)

    Maria Aparecida Junqueira Zampieri

    2014-08-01

    Full Text Available There are controversial associations between headaches and psychological symptoms. Objective To design a profile of neuroticism, a term that groups variables related to negative personality traits, in patients with chronic daily headache (CDH when compared to episodic migraine (EM patients, applying the Factorial Scale of Emotional Adjustment/Neuroticism (NFS. Method One hundred adult patients with CDH and forty with EM answered the NFS. Results Comorbidities of subtypes of neuroticism (p=0.006 were more common in chronic daily headache patients, with three or more disorders (p=0.0002: dependent personality disorder (p=0.0001, anxiety, reduced concentration and production (p=0.0008, depression (p<0.0001, suicidal ideation (p=0.0008 and hopelessness even without depression (p<0.0001. Conclusion Patients with CDH tend to have dependent personality disorder, low production and concentration, anxiety, depression, suicidal ideation and hopelessness, superimposing two or more psychological disorders. These factors should be pondered for a better resolution in the treatment of CDH.

  1. Neuromuscular strain as a contributor to cognitive and other symptoms in Chronic Fatigue Syndrome: Hypothesis and conceptual model.

    Directory of Open Access Journals (Sweden)

    Peter C. Rowe

    2013-05-01

    Full Text Available Individuals with chronic fatigue syndrome (CFS have heightened sensitivity and increased symptoms following various physiologic challenges, such as orthostatic stress, physical exercise, and cognitive challenges. Similar heightened sensitivity to the same stressors in fibromyalgia (FM has led investigators to propose that these findings reflect a state of central sensitivity. A large body of evidence supports the concept of central sensitivity in FM. A more modest literature provides partial support for this model in CFS, particularly with regard to pain. Nonetheless, fatigue and cognitive dysfunction have not been explained by the central sensitivity data thus far. Peripheral factors have attracted attention recently as contributors to central sensitivity. Work by Brieg, Sunderland, and others has emphasized the ability of the nervous system to undergo accommodative changes in length in response to the range of limb and trunk movements carried out during daily activity. If that ability to elongate is impaired—due to movement restrictions in tissues adjacent to nerves, or due to swelling or adhesions within the nerve itself—the result is an increase in mechanical tension within the nerve. This adverse neural tension, also termed neurodynamic dysfunction, is thought to contribute to pain and other symptoms through a variety of mechanisms. These include mechanical sensitization and altered nociceptive signaling, altered proprioception, adverse patterns of muscle recruitment and force of muscle contraction, reduced intra-neural blood flow, and release of inflammatory neuropeptides. Because it is not possible to differentiate completely between adverse neural tension and strain in muscles, fascia, and other soft tissues, we use the more general term neuromuscular strain. In our clinical work, we have found that neuromuscular restrictions are common in CFS, and that many symptoms of CFS can be reproduced by selectively adding neuromuscular strain

  2. 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.

  3. Reversal of Refractory Ulcerative Colitis and Severe Chronic Fatigue Syndrome Symptoms Arising from Immune Disturbance in an HLADR/DQ Genetically Susceptible Individual with Multiple Biotoxin Exposures

    Science.gov (United States)

    Gunn, Shelly R.; Gibson Gunn, G.; Mueller, Francis W.

    2016-01-01

    Patient: Male, 25 Final Diagnosis: Ulcerative colitis and chronic fatigue syndrome Symptoms: Colitis • profound fatigue • multi-joint pain • cognitive impairment • corneal keratitis Medication: — Clinical Procedure: VIP replacement therapy Specialty: Family Medicine Objective: Unusual clinical course Background: Patients with multisymptom chronic conditions, such as refractory ulcerative colitis (RUC) and chronic fatigue syndrome (CFS), present diagnostic and management challenges for clinicians, as well as the opportunity to recognize and treat emerging disease entities. In the current case we report reversal of co-existing RUC and CFS symptoms arising from biotoxin exposures in a genetically susceptible individual. Case Report: A 25-year-old previously healthy male with new-onset refractory ulcerative colitis (RUC) and chronic fatigue syndrome (CFS) tested negative for autoimmune disease biomarkers. However, urine mycotoxin panel testing was positive for trichothecene group and air filter testing from the patient’s water-damaged rental house identified the toxic mold Stachybotrys chartarum. HLA-DR/DQ testing revealed a multisusceptible haplotype for development of chronic inflammation, and serum chronic inflammatory response syndrome (CIRS) biomarker testing was positive for highly elevated TGF-beta and a clinically undetectable level of vasoactive intestinal peptide (VIP). Following elimination of biotoxin exposures, VIP replacement therapy, dental extractions, and implementation of a mind body intervention-relaxation response (MBI-RR) program, the patient’s symptoms resolved. He is off medications, back to work, and resuming normal exercise. Conclusions: This constellation of RUC and CFS symptoms in an HLA-DR/DQ genetically susceptible individual with biotoxin exposures is consistent with the recently described CIRS disease pathophysiology. Chronic immune disturbance (turbatio immuno) can be identified with clinically available CIRS biomarkers and

  4. [Chronic cough in the elderly is associated with expiratory flow limitation].

    Science.gov (United States)

    Frappé, E; Gautier-Guillot, M; Barthélémy, J-C; Maudoux, D; Roche, F; Costes, F

    2013-03-01

    As chronic respiratory symptoms and the presence of expiratory flow limitation (EFL) are commonly reported in the elderly, we investigated whether they were associated in a population of 75 years old volunteers. We analyzed the results of a prevalence survey of chronic respiratory symptoms and respiratory infections, and performed spirometry and measured EFL after application of a negative expiratory pressure at the mouth (NEP). EFL was present in 170 (46%) subjects, a chronic cough in 49 (13%), chronic sputum in 58 (29%) and a history of respiratory infection in 62 (17%). Chronic cough and the composite outcome "chronic cough or sputum" were significantly associated with the presence of EFL (respectively 60% vs. 43%, OR=2.04 [1.09 to 3.78], P=0.023, and 56% vs. 43%, OR=1.74 [1.05 to 2.87], P=0.04), after controlling for smoking or airway obstruction. History of respiratory infections were not associated with an increased prevalence of EFL. We concluded that the presence of a LED could be an interesting indicator of respiratory aging. Its detection could be advocated in elderly subjects presenting with respiratory symptoms. PMID:23497927

  5. The short-term effects of a body awareness program : better self-management of health problems for individuals with chronic a-specific psychosomatic symptoms

    NARCIS (Netherlands)

    Landsman-Dijkstra, Jeanet J. A.; van Wijck, R; Groothoff, JW; Rispens, P

    2004-01-01

    A three-day residential Body Awareness Program (BAP) was developed to teach people with Chronic A-specific Psychosomatic Symptoms (CAPS) to react adequately to disturbances of the balance between a daily workload and the capacity to deal with it. The short-term effects of the program for people with

  6. Predictive validity of BODE index for anxious and depressive symptoms in patients with chronic obstructive pulmonary disease

    Institute of Scientific and Technical Information of China (English)

    AN Li; LIN Ying-xiang; YANG Ting; ZHANG Hong; JIAO Xia; ZHANG Shu; CHANG Xiao-hong; WANG Zhao-mei; WANG Chen

    2010-01-01

    Background Anxiety and depression are two of the commonest and most modifiable comorbidities of chronic obstructive pulmonary disease (COPD) and have an independent effect on health and prognosis. FEV1% has been shown to be a poor predictor of anxiety and depression. The body mass index, degree of airflow obstruction, dyspnea,and exercise capacity (BODE) index is a multidimensional assessment system which may predict health outcome in COPD patients. The purpose of this study was to investigate the predictive validity of the BODE index for anxious and depressive symptoms in COPD patients.Methods This was a multicenter prospective cross-sectional study in 256 patients with stable COPD. Anxious and depressive symptoms were assessed using the Hospital Anxiety and Depression Scale (HADS). The relationships between anxiety, depression and potential predictors (including the BODE index) were analyzed by a binary Logistic regression model. Results Subjects who were anxious and depressive walked a shorter six-minute walking distance (6MWD), had more dyspnea, a higher BODE index, and lower health-related quality of life (P <0.01). Anxiety and depression score was significantly correlated with BODE index, respectively (r=0.335, P <0.001; r=0.306, P <0.001). The prevalence of anxiety and depression increased with BODE stage increasing (P <0.05). On the basis of binary Logistic regression, the BODE index was a good and independent predictor of anxiety and depression because it comprised dyspnea and 6MWD, which were shown to be the main determinants.Conclusions The predictive validity of the BODE index for anxiety and depression was demonstrated. We propose that the BODE index should be included in assessment of COPD severity.

  7. 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

  8. Gender and respiratory findings in workers occupationally exposed to organic aerosols: A meta analysis of 12 cross-sectional studies

    Directory of Open Access Journals (Sweden)

    Mustajbegovic Jadranka

    2009-01-01

    Full Text Available Abstract Background Gender related differences in respiratory disease have been documented. The aim of this study was to investigate gender related differences in respiratory findings by occupation. We analyzed data from 12 of our previously published studies. Methods Three thousand and eleven (3011 workers employed in "organic dust" industries (1379 female and 1632 male were studied. A control group of 806 workers not exposed to any kind of dust were also investigated (male = 419, female = 387. Acute and chronic respiratory symptoms and lung function were measured. The weighted average method and the Mantel-Haentszel method were used to calculate the odds ratios of symptoms. Hedge's unbiased estimations were used to measure lung function differences between men and women. Results There were high prevalences of acute and chronic respiratory symptoms in all the "dusty" studied groups compared to controls. Significantly less chronic cough, chronic phlegm as well as chronic bronchitis were found among women than among men after the adjustments for smoking, age and duration of employment. Upper respiratory tract symptoms by contrast were more frequent in women than in men in these groups. Significant gender related lung function differences occurred in the textile industry but not in the food processing industry or among farmers. Conclusion The results of this study suggest that in industries processing organic compounds there are gender differences in respiratory symptoms and lung function in exposed workers. Whether these findings represent true physiologic gender differences, gender specific workplace exposures or other undefined gender variables not defined in this study cannot be determined. These data do not suggest that special limitations for women are warranted for respiratory health reasons in these industries, but the issue of upper respiratory irritation and disease warrants further study.

  9. Respiratory Failure

    Directory of Open Access Journals (Sweden)

    Ezgi Ozyilmaz

    2014-06-01

    Full Text Available The main function of the lungs is to maintain the exchange between the pulmonary capillary and the air in the alveoli. By this way, the arteriel oxygen and carbondioxide tension remains constant. Respiratory failure is a syndrome which is defined as the loss of the ability of respiratory system to exchange oxygen and carbondioxide elimination function. The main pathophysiological causes of respiratory failure include ventilation-perfusion mismatch, alveolar hypoventilation, impaired diffusion capacity and increased shunt. A number of diseases may result in respiratory failure by different pathophysiological reasons. The most common causes are Type 1 (hypoxemic and Type 2 (hypercapnic respiratory failure. When suspected with clinical signs and symptoms, the diagnosis should be confirmed with arterial blood gases. At this step, other diagnostic interventions, which could be performed, may be used to enlighten the underlying pathophysiological cause. Although the main therapeutic approach is similar, specific treatment are also required based on the underlying cause. The basic pathophysiological points, diagnosis and basic treatment approach have been evaluated in this review article. [Cukurova Med J 2014; 39(3.000: 428-442

  10. Diversity and Evolutionary Histories of Human Coronaviruses NL63 and 229E Associated with Acute Upper Respiratory Tract Symptoms in Kuala Lumpur, Malaysia.

    Science.gov (United States)

    Al-Khannaq, Maryam Nabiel; Ng, Kim Tien; Oong, Xiang Yong; Pang, Yong Kek; Takebe, Yutaka; Chook, Jack Bee; Hanafi, Nik Sherina; Kamarulzaman, Adeeba; Tee, Kok Keng

    2016-05-01

    The human alphacoronaviruses HCoV-NL63 and HCoV-229E are commonly associated with upper respiratory tract infections (URTI). Information on their molecular epidemiology and evolutionary dynamics in the tropical region of southeast Asia however is limited. Here, we analyzed the phylogenetic, temporal distribution, population history, and clinical manifestations among patients infected with HCoV-NL63 and HCoV-229E. Nasopharyngeal swabs were collected from 2,060 consenting adults presented with acute URTI symptoms in Kuala Lumpur, Malaysia, between 2012 and 2013. The presence of HCoV-NL63 and HCoV-229E was detected using multiplex polymerase chain reaction (PCR). The spike glycoprotein, nucleocapsid, and 1a genes were sequenced for phylogenetic reconstruction and Bayesian coalescent inference. A total of 68/2,060 (3.3%) subjects were positive for human alphacoronavirus; HCoV-NL63 and HCoV-229E were detected in 45 (2.2%) and 23 (1.1%) patients, respectively. A peak in the number of HCoV-NL63 infections was recorded between June and October 2012. Phylogenetic inference revealed that 62.8% of HCoV-NL63 infections belonged to genotype B, 37.2% was genotype C, while all HCoV-229E sequences were clustered within group 4. Molecular dating analysis indicated that the origin of HCoV-NL63 was dated to 1921, before it diverged into genotype A (1975), genotype B (1996), and genotype C (2003). The root of the HCoV-229E tree was dated to 1955, before it diverged into groups 1-4 between the 1970s and 1990s. The study described the seasonality, molecular diversity, and evolutionary dynamics of human alphacoronavirus infections in a tropical region.

  11. 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...

  12. Effect of recombinant human interleukin-2 on the course of experimental chronic respiratory tract infection caused by Klebsiella pneumoniae in mice.

    OpenAIRE

    Iizawa, Y; Nishi, T; Kondo, M.; Tsuchiya, K.; Imada, A

    1988-01-01

    The effect of recombinant human interleukin-2 (rIL-2) on the course of experimental chronic respiratory tract infection caused by Klebsiella pneumoniae in mice was examined. rIL-2 was administered subcutaneously once a day for 7 or 14 days, starting 2 weeks after the mice were infected. Administration of 2 or 20 micrograms of rIL-2 per mouse daily for 7 days reduced bacterial counts in the lungs dose dependently. At a dose of 0.2 microgram per day, proliferation of bacteria in the lungs was s...

  13. 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...

  14. 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 ...

  15. “Ninjinto” (Ginseng Decoction, a Traditional Japanese Herbal Medicine, Improves Gastrointestinal Symptoms and Immune Competence in Patients with Chronic Intestinal Failure

    Directory of Open Access Journals (Sweden)

    Shuichiro Uehara

    2015-01-01

    Full Text Available Background. Treating functional gastrointestinal disorders is extremely difficult. We herein report the effect of the oral administration of Ninjinto (NJT, ginseng decoction, a traditional Japanese Kampo medicine, on chronic intestinal failure. Patients and Methods. Seven patients with chronic intestinal failure treated with NJT were evaluated in this study. The primary diseases included chronic intestinal pseudoobstruction (CIPO: n=4, short bowel syndrome (SBS: n=2, and intestinal atresia n=1. All patients orally received NJT extract granules at a dose of 0.3 g/kg BW per day. The treatment outcomes were then assessed according to the patients’ symptoms and consecutive abdominal X-ray findings. Results. The targeted symptoms were abdominal distension in four patients, diarrhea in three patients, and frequent hospitalization due to infections in two patients. An improvement in the symptoms was observed in six of the seven patients, whereas one patient with SBS did not show any improvement. An improvement in an abdominal roentgenogram was observed in the four patients with remarkably dilated bowel loops due to CIPO. Conclusions. NJT may be effective in controlling functional gastrointestinal disorders associated with chronic intestinal failure. The use of Kampo medicine in the field of pediatric surgery may help to improve the quality of life in children suffering from such conditions.

  16. Fatigue, sleep-wake pattern, depressive and anxiety symptoms and body-mass index: analysis in a sample of episodic and chronic migraine patients.

    Science.gov (United States)

    Lucchesi, Cinzia; Baldacci, Filippo; Cafalli, Martina; Dini, Elisa; Giampietri, Linda; Siciliano, Gabriele; Gori, Sara

    2016-06-01

    Migraine clinical presentation and life-time course can be highly heterogeneous, with a subgroup of patients developing chronic migraine; moreover, migraine clinical spectrum is expanded by the association with different coexisting conditions and interictal dysfunctions. The aim of this study was to systematically evaluate migraine clinical features, daily functioning parameters, sleep pattern, presence of depressive-anxiety symptoms and body mass index (BMI) in a sample of 75 episodic and 75 chronic migraine without aura patients. Migraine-related disability, fatigue, daily sleepiness, subjective sleep quality, anxiety and depressive symptoms were, respectively, evaluated using the following questionnaires: Fatigue Severity Scale (FSS), Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index (PSQI), Generalized Anxiety Disorder 7-item Scale (GAD-7), Patient Health Questionnaire 9-item Scale (PHQ-9). Mean FSS score (p anxiety-depressive symptoms and higher BMI score in chronic compared to episodic migraine patients; further investigation is certainly necessary to better define the biological basis and mechanisms associated with migraine transformation from episodic to chronic pattern. PMID:26879311

  17. 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....

  18. The association of hiatal hernia with increased risk of respiratory symptoms%食管裂孔疝与呼吸道症状临床相关性研究

    Institute of Scientific and Technical Information of China (English)

    李治仝; 汪忠镐; 吴继敏; 季锋; 李震; 胡志伟; 高翔; 宁雅婵

    2013-01-01

    目的 探讨食管裂孔疝(hiatal hernia,HH)与呼吸道症状相关性.方法 2009年1-12月在胃食管反流中心收集HH住院患者,分别对其性别、年龄、临床症状及诊治进行临床分析.结果 在362例胃食管反流疾病(gastroesophageal reflux disease,GERD)患者中,196例有HH(54.1%),其中132例有呼吸道症状,64例无呼吸道症状,结果显示HH与呼吸道症状有相关性(x2=15.3,P=0).进一步多变量分析研究显示HH能增加呼吸道症状的风险(优势比OR值2.3,95%可信区间CI 1.5~3.6).196例HH患者中,178例行胃底折叠术并裂孔疝修补术,7例行胃底折叠术,11例保守治疗,术后168例疝修补术患者得到随访,平均随访(12±3)个月;7例胃底折叠术患者平均随访(12±4)个月,总有效率85.1%.结论 HH发病隐匿,由于其独特的形成因素,HH能增加反流及呼吸道症状的风险.通过有效的诊断并积极治疗HH,能显著减轻反流及其引起的呼吸道症状.%Objective To observe the correlation between hiatal hernia(HH) and respiratory symptoms.Methods A retrospective data analysis was conducted using electronic medical records of HH patients suffering from gastroesophageal reflux disease (GERD) enrolled between January and December 2009.Clinical features including sex,age,symptoms,diagnosis,and treatment were analyzed.All the patients were requested to answer a questionnaire regarding the severity and frequency of symptoms to make an evaluating score for the follow-up.Results 362 cases of GERD patients were collected in the Center of Gastroesophageal Reflux Disease,196 cases had HH (54.1%),of which 132 cases with respiratory symptoms,64 cases without.All HH patients were analyzed,HH was correlated with respiratory symptoms (x2 =15.3,P =0).Multivariate analyses showed that HH could increase the risk of respiratory symptoms (odds ratio =2.3,95% confidence interval 1.5-3.6).One hundred seventy-eight patients underwent fundoplication plus hernia

  19. Association between Serum Ferritin Concentrations and Depressive Symptoms among Chinese Adults: A Population Study from the Tianjin Chronic Low-Grade Systemic Inflammation and Health (TCLSIHealth) Cohort Study.

    Science.gov (United States)

    Su, Qian; Gu, Yeqing; Yu, Bin; Yu, Fei; He, Haiyan; Zhang, Qing; Meng, Ge; Wu, Hongmei; Du, Huanmin; Liu, Li; Shi, Hongbin; Xia, Yang; Guo, Xiaoyan; Liu, Xing; Li, Chunlei; Bao, Xue; Liu, Fangfang; Fang, Liyun; Yang, Huijun; Sun, Shaomei; Wang, Xing; Zhou, Ming; Jia, Qiyu; Zhao, Honglin; Song, Kun; Niu, Kaijun

    2016-01-01

    Depressive symptoms have become the most important global public health issue. Iron plays an important role in brain function, cognition, and behavior, and its impacts on depressive symptoms may be multifactorial with both positive and negative effects. Previous observational studies focusing on the association between iron status and depressive symptoms showed inconsistent results. Ferritin is a ubiquitous intracellular protein that can store and release iron and is widely used as a clinical biomarker to evaluate iron status. We performed a cross-sectional study to examine the relationship between serum ferritin and depressive symptoms among 3,839 subjects who were from the Tianjin Chronic Low-grade Systemic Inflammation and Health (TCLSIHealth) cohort. Depressive symptoms were assessed using the Chinese version of 20-item self-rating Depression Scale (SDS) with 4 cutoffs (40, 45, 48 and 50) to indicate elevated depressive symptoms (40 was the primary cut-off). The prevalence of depressive symptoms was 36.5%, 17.6%, 11.0% and 7.0% for SDS ≥40, ≥45, ≥48 and ≥50, respectively. With the primary cut-off point of 40, multiple potential confounding factors were adjusted and the odds ratios (95% confidence interval) of having elevated depressive symptoms by quartiles of serum ferritin concentrations were 1.00 (reference), 1.10 (0.91, 1.34), 0.81 (0.66, 1.01) and 1.02 (0.81, 1.28) for the first, second, third and fourth quartile, respectively (P for trend = 0.76). Similar relations were observed with the use of other cut-offs as a definition of depressive symptoms. In conclusion, there is no significant relationship between serum ferritin concentrations and depressive symptoms among Chinese adults. PMID:27611581

  20. Association between Serum Ferritin Concentrations and Depressive Symptoms among Chinese Adults: A Population Study from the Tianjin Chronic Low-Grade Systemic Inflammation and Health (TCLSIHealth) Cohort Study.

    Science.gov (United States)

    Su, Qian; Gu, Yeqing; Yu, Bin; Yu, Fei; He, Haiyan; Zhang, Qing; Meng, Ge; Wu, Hongmei; Du, Huanmin; Liu, Li; Shi, Hongbin; Xia, Yang; Guo, Xiaoyan; Liu, Xing; Li, Chunlei; Bao, Xue; Liu, Fangfang; Fang, Liyun; Yang, Huijun; Sun, Shaomei; Wang, Xing; Zhou, Ming; Jia, Qiyu; Zhao, Honglin; Song, Kun; Niu, Kaijun

    2016-01-01

    Depressive symptoms have become the most important global public health issue. Iron plays an important role in brain function, cognition, and behavior, and its impacts on depressive symptoms may be multifactorial with both positive and negative effects. Previous observational studies focusing on the association between iron status and depressive symptoms showed inconsistent results. Ferritin is a ubiquitous intracellular protein that can store and release iron and is widely used as a clinical biomarker to evaluate iron status. We performed a cross-sectional study to examine the relationship between serum ferritin and depressive symptoms among 3,839 subjects who were from the Tianjin Chronic Low-grade Systemic Inflammation and Health (TCLSIHealth) cohort. Depressive symptoms were assessed using the Chinese version of 20-item self-rating Depression Scale (SDS) with 4 cutoffs (40, 45, 48 and 50) to indicate elevated depressive symptoms (40 was the primary cut-off). The prevalence of depressive symptoms was 36.5%, 17.6%, 11.0% and 7.0% for SDS ≥40, ≥45, ≥48 and ≥50, respectively. With the primary cut-off point of 40, multiple potential confounding factors were adjusted and the odds ratios (95% confidence interval) of having elevated depressive symptoms by quartiles of serum ferritin concentrations were 1.00 (reference), 1.10 (0.91, 1.34), 0.81 (0.66, 1.01) and 1.02 (0.81, 1.28) for the first, second, third and fourth quartile, respectively (P for trend = 0.76). Similar relations were observed with the use of other cut-offs as a definition of depressive symptoms. In conclusion, there is no significant relationship between serum ferritin concentrations and depressive symptoms among Chinese adults.

  1. Association between Serum Ferritin Concentrations and Depressive Symptoms among Chinese Adults: A Population Study from the Tianjin Chronic Low-Grade Systemic Inflammation and Health (TCLSIHealth) Cohort Study

    Science.gov (United States)

    Yu, Bin; Yu, Fei; He, Haiyan; Zhang, Qing; Meng, Ge; Wu, Hongmei; Du, Huanmin; Liu, Li; Shi, Hongbin; Xia, Yang; Guo, Xiaoyan; Liu, Xing; Li, Chunlei; Bao, Xue; Liu, Fangfang; Fang, Liyun; Yang, Huijun; Sun, Shaomei; Wang, Xing; Zhou, Ming; Jia, Qiyu; Zhao, Honglin; Song, Kun; Niu, Kaijun

    2016-01-01

    Depressive symptoms have become the most important global public health issue. Iron plays an important role in brain function, cognition, and behavior, and its impacts on depressive symptoms may be multifactorial with both positive and negative effects. Previous observational studies focusing on the association between iron status and depressive symptoms showed inconsistent results. Ferritin is a ubiquitous intracellular protein that can store and release iron and is widely used as a clinical biomarker to evaluate iron status. We performed a cross-sectional study to examine the relationship between serum ferritin and depressive symptoms among 3,839 subjects who were from the Tianjin Chronic Low-grade Systemic Inflammation and Health (TCLSIHealth) cohort. Depressive symptoms were assessed using the Chinese version of 20-item self-rating Depression Scale (SDS) with 4 cutoffs (40, 45, 48 and 50) to indicate elevated depressive symptoms (40 was the primary cut-off). The prevalence of depressive symptoms was 36.5%, 17.6%, 11.0% and 7.0% for SDS ≥40, ≥45, ≥48 and ≥50, respectively. With the primary cut-off point of 40, multiple potential confounding factors were adjusted and the odds ratios (95% confidence interval) of having elevated depressive symptoms by quartiles of serum ferritin concentrations were 1.00 (reference), 1.10 (0.91, 1.34), 0.81 (0.66, 1.01) and 1.02 (0.81, 1.28) for the first, second, third and fourth quartile, respectively (P for trend = 0.76). Similar relations were observed with the use of other cut-offs as a definition of depressive symptoms. In conclusion, there is no significant relationship between serum ferritin concentrations and depressive symptoms among Chinese adults. PMID:27611581

  2. Translation, Cross-Cultural Adaptation, and Validation of the Lee Chronic Graft-versus-Host Disease Symptom Scale in a Brazilian Population.

    Science.gov (United States)

    Vasconcellos de Souza, Clarissa; Vigorito, Afonso Celso; Miranda, Eliana C M; Garcia, Celso; Rensi Colturato, Vergílio Antonio; Mauad, Marcos Augusto; Rodrigues Moreira, Maria Cláudia; da Silva Bouzas, Luis Fernando; Lermontov, Simone; Hamerschlak, Nelson; Rodrigues, Morgani; Carlos de Almeida Barros, Jose; Chiattone, Ricardo; Lee, Stephanie J; Flowers, Mary E D

    2016-07-01

    The Lee Chronic Graft-versus-Host Disease (GVHD) Symptom Scale is a patient-reported instrument developed and validated in English to measure the symptoms and functional impact of cGVHD. This tool has not yet been validated in a Latin American population, however. The Brazil-Seattle Chronic GVHD Consortium conducted a multicenter study at 5 Brazilian institutions to validate the Lee cGVHD Symptom Scale in adults with cGVHD. Study objectives included the translation and validation of the instrument in Brazilian Portuguese and evaluation of the correlation with other quality of life (QoL) tools, including the Medical Outcomes Study Short Form 36 (SF-36) and Functional Assessment of Chronic Illness Therapy with Bone Marrow Transplant subscale (FACT-BMT). Translation and validation were done according to the American Association of Orthopedic Surgeons Outcome Committee guidelines. Spearman's correlation coefficient was used to measure construct validity. Reliability was assessed using Cronbach's α and intraclass correlation coefficients. Between April 2011 and August 2012, 47 patients with cGVHD based on the 2005 National Institutes of Health criteria (29 males [62%], 18 females [38%]; median age, 48 years; range, 23 to 69 years) were enrolled in this study. The reliability of the Lee cGVHD Symptom Scale was adequate (Cronbach's α = 0.62 to 0.83). The correlations between similar domains of the Lee cGVHD Symptom Scale, SF-36, and FACT-BMT were moderate to high. Our data indicate that the Brazilian Portuguese version of the Lee cGVHD Symptom Scale is valid and reliable and can be used in clinical trials of cGVHD in Brazil. PMID:27058616

  3. Itch, pain, and burning sensation are common symptoms in mild to moderate chronic venous insufficiency with an impact on quality of life.

    Science.gov (United States)

    Duque, Maria I; Yosipovitch, Gil; Chan, Yiong Huak; Smith, Ronald; Levy, Pavel

    2005-09-01

    To our knowledge there are no studies evaluating the prevalence and characteristics of itch, pain, and burning sensation among patients with mild to moderate chronic venous insufficiency or assessing the impact of these symptoms on quality of life. In this report 100 patients met the inclusion criteria. Patients who suffered from itch were also assessed with the use of a validated questionnaire and a modified Skindex-16 questionnaire. We found that the prevalence of itch was 66%. Concomitant itch and burning sensation as well as itch and pain were noted in 47% and 44% of the patients, respectively. No correlation was noted between the severity of these symptoms and the degree of venous insufficiency. Itch had a negative impact on quality of life. A limitation of this study is that the participants, who were primarily hospital employees, are more likely to develop these symptoms. Therefore this study does not reflect the true prevalence of these symptoms in the general population. This study found that itch, pain, and burning sensation are common symptoms of mild to moderate chronic venous insufficiency with a significant impact on quality of life. PMID:16112363

  4. Reversal of Refractory Ulcerative Colitis and Severe Chronic Fatigue Syndrome Symptoms Arising from Immune Disturbance in an HLA-DR/DQ Genetically Susceptible Individual with Multiple Biotoxin Exposures.

    Science.gov (United States)

    Gunn, Shelly R; Gunn, G Gibson; Mueller, Francis W

    2016-01-01

    BACKGROUND Patients with multisymptom chronic conditions, such as refractory ulcerative colitis (RUC) and chronic fatigue syndrome (CFS), present diagnostic and management challenges for clinicians, as well as the opportunity to recognize and treat emerging disease entities. In the current case we report reversal of co-existing RUC and CFS symptoms arising from biotoxin exposures in a genetically susceptible individual. CASE REPORT A 25-year-old previously healthy male with new-onset refractory ulcerative colitis (RUC) and chronic fatigue syndrome (CFS) tested negative for autoimmune disease biomarkers. However, urine mycotoxin panel testing was positive for trichothecene group and air filter testing from the patient's water-damaged rental house identified the toxic mold Stachybotrys chartarum. HLA-DR/DQ testing revealed a multisusceptible haplotype for development of chronic inflammation, and serum chronic inflammatory response syndrome (CIRS) biomarker testing was positive for highly elevated TGF-beta and a clinically undetectable level of vasoactive intestinal peptide (VIP). Following elimination of biotoxin exposures, VIP replacement therapy, dental extractions, and implementation of a mind body intervention-relaxation response (MBI-RR) program, the patient's symptoms resolved. He is off medications, back to work, and resuming normal exercise. CONCLUSIONS This constellation of RUC and CFS symptoms in an HLA-DR/DQ genetically susceptible individual with biotoxin exposures is consistent with the recently described CIRS disease pathophysiology. Chronic immune disturbance (turbatio immuno) can be identified with clinically available CIRS biomarkers and may represent a treatable underlying disease etiology in a subset of genetically susceptible patients with RUC, CFS, and other immune disorders. PMID:27165859

  5. Associations of indoor carbon dioxide concentrations, VOCS, environmental susceptibilities with mucous membrane and lower respiratory sick building syndrome symptoms in the BASE study: Analyses of the 100 building dataset

    Energy Technology Data Exchange (ETDEWEB)

    Apte, M.G.; Erdmann, C.A.

    2002-10-01

    Using the 100 office-building Building Assessment Survey and Evaluation (BASE) Study dataset, we performed multivariate logistic regression analyses to quantify the associations between indoor minus outdoor CO{sub 2} (dCO{sub 2}) concentrations and mucous membrane (MM) and lower respiratory system (Lresp) Sick Building Syndrome (SBS) symptoms, adjusting for age, sex, smoking status, presence of carpet in workspace, thermal exposure, relative humidity, and a marker for entrained automobile exhaust. Using principal components analysis we identified a number of possible sources of 73 measured volatile organic compounds in the office buildings, and assessed the impact of these VOCs on the probability of presenting the SBS symptoms. Additionally we included analysis adjusting for the risks for predisposition of having SBS symptoms associated with the allergic, asthmatic, and environmentally sensitive subpopulations within the office buildings. Adjusted odds ratios (ORs) for statistically significant, dose-dependant associations (p<0.05) for dry eyes, sore throat, nose/sinus congestion, and wheeze symptoms with 100-ppm increases in dCO{sub 2} ranged from 1.1 to 1.2. These results suggest that increases in the ventilation rates per person among typical office buildings will, on average significantly reduce the prevalence of several SBS symptoms, up to 80%, even when these buildings meet the existing ASHRAE ventilation standards for office buildings. VOC sources were observed to play an role in direct association with mucous membrane and lower respiratory irritation, and possibly to be indirectly involved in indoor chemical reactions with ozone that produce irritating compounds associated with SBS symptoms. O-xylene, possibly emitted from furniture coatings was associated with shortness of breath (OR at the maximum concentration = 8, p < 0.05). The environmental sensitivities of a large subset of the office building population add to the overall risk of SBS symptoms (ORs

  6. 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.

  7. An educational approach based on a non-injury model compared with individual symptom-based physical training in chronic LBP

    DEFF Research Database (Denmark)

    Sorensen, Pia H; Bendix, Tom; Manniche, Claus;

    2010-01-01

    In the treatment of chronic back pain, cognitive methods are attracting increased attention due to evidence of effectiveness similar to that of traditional therapies. The purpose of this study was to compare the effectiveness of performing a cognitive intervention based on a non-injury model with...... with that of a symptom-based physical training method on the outcomes of low back pain (LBP), activity limitation, LBP attitudes (fear-avoidance beliefs and back beliefs), physical activity levels, sick leave, and quality of life, in chronic LBP patients....

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

    Directory of Open Access Journals (Sweden)

    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.

  9. Ventilation/perfusion SPECT in chronic obstructive pulmonary disease: an evaluation by reference to symptoms, spirometric lung function and emphysema, as assessed with HRCT.

    OpenAIRE

    Jögi, Jonas; Ekberg, Marie; Jonson, Björn; Bozovic, Gracijela; Bajc, Marika

    2011-01-01

    PURPOSE: Chronic obstructive pulmonary disease (COPD) is characterized by airflow limitation which is not fully reversible. Despite the heterogeneity of COPD, its diagnosis and staging is currently based solely on forced expiratory volume in 1 s (FEV(1)). FEV(1) does not explain the underlying pathophysiology of airflow limitation. The relationship between FEV(1), symptoms and emphysema extent is weak. Better diagnostic tools are needed to define COPD. Tomographic lung scintigraphy [ventilati...

  10. 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.

  11. Outcomes of a Telehealth Intervention for Homebound Older Adults with Heart or Chronic Respiratory Failure: A Randomized Controlled Trial

    Science.gov (United States)

    Gellis, Zvi D.; Kenaley, Bonnie; McGinty, Jean; Bardelli, Ellen; Davitt, Joan; Ten Have, Thomas

    2012-01-01

    Purpose: Telehealth care is emerging as a viable intervention model to treat complex chronic conditions, such as heart failure (HF) and chronic obstructive pulmonary disease (COPD), and to engage older adults in self-care disease management. Design and Methods: We report on a randomized controlled trial examining the impact of a multifaceted…

  12. Symptoms and quality of life in patients with chronic obstructive pulmonary disease treated with aclidinium in a real-life setting

    DEFF Research Database (Denmark)

    Lange, Peter; Godtfredsen, Nina Skavlan; Olejnicka, Beata;

    2016-01-01

    Introduction: Chronic obstructive pulmonary disease (COPD) is a progressive disease with symptoms that can have a major impact on patients' physical health. The aim of this study was to evaluate quality of life (QoL), symptom severity and dyspnoea in COPD patients treated with aclidinium up to 24...... assessment test (CAT). Symptoms were evaluated on a 6-point Likert scale. The modified Medical Research Council (mMRC) Dyspnoea Scale was used as a simple grading system to assess the level of dyspnoea/shortness of breath from0 to 4. Patients on treatment with aclidinium who completed baseline and at least.......9 (7.7) at baseline to 14.3 (7.3) at week 24 (p (pScale changed from 1.6 (1...

  13. Self-reported somatosensory symptoms of neuropathic pain in fibromyalgia and chronic widespread pain correlate with tender point count and pressure-pain thresholds

    DEFF Research Database (Denmark)

    Amris, Kirstine; Jespersen, Anders; Bliddal, Henning

    2010-01-01

    of patients with chronic widespread pain (CWP). The aims of the study were to assess the patient-reported sensory neuropathic symptoms by PDQ and to correlate these with tender point (TP) count and pressure-pain thresholds. Eighty-one patients (75 F, 6 M) with CWP (ACR-criteria) filled in the PDQ. Manual TP......-37). Mean PDT was 8.8 kPa (range: 2-36) and mean PTT 30.9 kPa (range: 4-85). Deep-tissue hyperalgesia was the predominant somatosensory symptom reported in 83%, but other neuropathic symptoms were also frequent, e.g. burning 51% and prickling 47%. Statistically significant correlations were found between...

  14. Pilot study investigating the utility of a specialized online symptom management program for individuals with myalgic encephalomyelitis/chronic fatigue syndrome as compared to an online meditation program

    Directory of Open Access Journals (Sweden)

    Arroll MA

    2014-09-01

    Full Text Available Megan A Arroll, Elizabeth A Attree, Claire L Marshall, Christine P DanceyChronic Illness Research Team, School of Psychology, University of East London, London, UKBackground: Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS is a long-term, debilitating condition that impacts numerous areas of individuals' lives. The two predominant treatment options for ME/CFS are cognitive behavioral therapy and graded exercise therapy; however, many people have found these techniques unacceptable or even damaging. This pilot study aimed to evaluate the utility of a specialized online symptom management program for ME/CFS in comparison to an online meditation program in an effort to ascertain whether this tool could be a further option for those with ME/CFS.Methods: This experimental design consisted of two interventions: a specialized online symptoms management program (N=19 and a control intervention based on an online meditation website (N=9. A battery of questionnaires, including measures of multidimensional fatigue, illness-specific symptoms, perceived control, and mindful awareness, were completed before the participants commenced use of the programs and following 8 weeks' use.Results: Significant differences were found in the areas of chance and powerful others' locus of control, and sleeping difficulties, but not in ME/CFS symptomatology overall.Conclusion: The specialized online program described in this study warrants further investigation, as it appears to influence perceived control and key ME/CFS symptoms over time.Keywords: ME/CFS, perceived control, sleep, outcomes, online intervention

  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. 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

  17. Acute effects of particulate matter on respiratory diseases, symptoms and functions:. epidemiological results of the Austrian Project on Health Effects of Particulate Matter (AUPHEP)

    Science.gov (United States)

    Neuberger, Manfred; Schimek, Michael G.; Horak, Friedrich; Moshammer, Hanns; Kundi, Michael; Frischer, Thomas; Gomiscek, Bostjan; Puxbaum, Hans; Hauck, Helger; Auphep-Team

    To examine hypotheses regarding health effects of particulate matter, we conducted time series studies in Austrian urban and rural areas. Of the pollutants measured, ambient PM 2.5 was most consistently associated with parameters of respiratory health. Time series studies applying semiparametric generalized additive models showed significant increases of respiratory hospital admissions (ICD 490-496) at age 65 and older. The early increase of 5.5% in Vienna at a lag of 2 days in males and of 5.6% per 10 μg/m 3 at a lag of 3 days in females was not observed in a nearby rural area. Another increase of respiratory admissions (mainly COPD) was observed after a lag of 10-11 days. A time series on a panel of 56 healthy preschool children showed a significant impact of the carbonaceous fraction of PM 2.5 on tidal breathing pattern assessed by inductive plethysmography. In repeated oscillometric measurements of respiratory resistance in 164 healthy elementary school children not only immediate responses to fine particulates were found but also latent ones, possibly indicating inflammatory changes in airways. It may be speculated that the improvements of urban air quality prevented measurable effects on respiratory mortality. More sensitive indicators, however, still show acute impairments of respiratory function and health in elderly and children which are associated with fine particulates and subfractions related to motor traffic.

  18. 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

  19. Chronic Dosing with Membrane Sealant Poloxamer 188 NF Improves Respiratory Dysfunction in Dystrophic Mdx and Mdx/Utrophin-/- Mice.

    Directory of Open Access Journals (Sweden)

    Bruce E Markham

    Full Text Available Poloxamer 188 NF (national formulary (NF grade of P-188 improves cardiac muscle function in the mdx mouse and golden retriever muscular dystrophy models. However in vivo effects on skeletal muscle have not been reported. We postulated that P-188 NF might protect diaphragm muscle membranes from contraction-induced injury in mdx and mdx/utrophin-/- (dko muscular dystrophy models. In the first study 7-month old mdx mice were treated for 22 weeks with subcutaneous (s.c. injections of saline or P-188 NF at 3 mg/Kg. In the second, dkos were treated with saline or P-188 NF (1 mg/Kg for 8 weeks beginning at age 3 weeks. Prednisone was the positive control in both studies. Respiratory function was monitored using unrestrained whole body plethysmography. P-188 NF treatment affected several respiratory parameters including tidal volume/BW and minute volume/BW in mdx mice. In the more severe dko model, P-188 NF (1 mg/Kg significantly slowed the decline in multiple respiratory parameters compared with saline-treated dko mice. Prednisone's effects were similar to those seen with P-188 NF. Diaphragms from P-188 NF or prednisone treated mdx and dko mice showed signs of muscle fiber protection including less centralized nuclei, less variation in fiber size, greater fiber density, and exhibited a decreased amount of collagen deposition. P-188 NF at 3 mg/Kg s.c. also improved parameters of systolic and diastolic function in mdx mouse hearts. These results suggest that P-188 NF may be useful in treating respiratory and cardiac dysfunction, the leading causes of death in Duchenne muscular dystrophy patients.

  20. 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

  1. Occupational exposure to poultry dust and effects on the respiratory system in workers.

    Science.gov (United States)

    Viegas, S; Faísca, V M; Dias, H; Clérigo, A; Carolino, E; Viegas, C

    2013-01-01

    Farmers are occupationally exposed to many respiratory hazards at work and display higher rates of asthma and respiratory symptoms than other workers. Dust is one of the components present in poultry production that increases risk of adverse respiratory disease occurrence. Dust originates from poultry residues, molds, and feathers and is biologically active as it contains microorganisms. Exposure to dust is known to produce a variety of clinical responses, including asthma, chronic bronchitis, chronic airways obstructive disease (COPD), allergic alveolitis, and organic dust toxic syndrome (ODTS). A study was developed to determine particle contamination in seven poultry farms and correlate this with prevalence rate of respiratory defects and record by means of a questionnaire the presence of clinical symptoms associated with asthma and other allergy diseases by European Community Respiratory Health Survey. Poultry farm dust contamination was found to contain higher concentrations of particulate matter (PM) PM5 and PM10. Prevalence rate of obstructive pulmonary disorders was higher in individuals with longer exposure regardless of smoking status. In addition, a high prevalence for asthmatic (42.5%) and nasal (51.1%) symptoms was noted in poultry workers. Data thus show that poultry farm workers are more prone to suffer from respiratory ailments and this may be attributed to higher concentrations of PM found in the dust. Intervention programs aimed at reducing exposure to dust will ameliorate occupational working conditions and enhance the health of workers. PMID:23514065

  2. 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.

  3. Respiratory System

    Science.gov (United States)

    ... page from the NHLBI on Twitter. The Respiratory System The respiratory system is made up of organs ... and the muscles that enable breathing. The Respiratory System Figure A shows the location of the respiratory ...

  4. Symptoms in patients with skin changes due to chronic venous insufficiency often lead to emergency care service: an Italian observational study.

    Science.gov (United States)

    Ruggiero, Michele; Grande, Raffaele; Naso, Agostino; Butrico, Lucia; Rubino, Paolo; Placida, Girolamo Domenico; Cannistrà, Marco; Serra, Raffaele

    2016-10-01

    Chronic venous insufficiency (CVI) is the most advanced form of chronic venous disease (CVD), and is often associated with skin changes such as hyperpigmentation, eczema, lipodermatosclerosis and venous skin ulceration that cause discomfort, pain, sleep disturbances, absenteeism in the workplace, disability and deteriorated quality of life (QoL). The purpose of this study is to evaluate the prevalence of CVI and skin changes in patients who turn to Continuous Assistance Services due to the presence of disturbing symptoms of their condition. Data were evaluated by consulting the medical records, during a 16-month period, available with three Continuous Assistance Services of the Italian territory. The overall population of the referring centres consisted of 1186 patients [739 females (62·31%) and 447 males (37·69%)]. Seventy-nine patients (6·66%) consulted the emergency unit for venous symptoms related to CVD. Patients with more severe disease (CVI, categories C4-C6) represented the majority accounting for 60·75%, while patients with moderate disease (C3) accounted for 35·44% and patients with mild disease (C1-C2 stages) accounted for 3·79%. The main finding of this study is that despite CVI not being a disease that commonly requires medical emergency/urgency intervention, patients with CVI, especially in advanced stage with skin changes, may turn to Continuous Assistance Service for treating bothersome symptoms related to their condition.

  5. Exacerbation of daily cough and allergic symptoms in adult patients with chronic cough by Asian dust: A hospital-based study in Kanazawa

    Science.gov (United States)

    Higashi, Tomomi; Kambayashi, Yasuhiro; Ohkura, Noriyuki; Fujimura, Masaki; Nakanishi, Sayaka; Yoshizaki, Tomokazu; Saijoh, Kiyofumi; Hayakawa, Kazuichi; Kobayashi, Fumihisa; Michigami, Yoshimasa; Hitomi, Yoshiaki; Nakamura, Hiroyuki

    2014-11-01

    The health effects associated with Asian dust have attracted attention due to the rapid increase in the number of Asian dust events in East Asia in recent years. The aim of this study was to investigate the associations between Asian dust and daily cough, as well as allergic symptoms, in adult patients who suffer from chronic cough. We enrolled 86 adult patients from Kanazawa University Hospital, Japan, who were diagnosed with asthma, cough variant asthma, atopic cough or a combination of these conditions. From January to June 2011, subjects recorded their symptoms in a diary every day. Asian dust and non-Asian dust periods were defined according to the dust extinction coefficient, measured using the light detection and ranging (LIDAR). The daily levels of total suspended particulates, polycyclic aromatic hydrocarbons (PAHs) and coexisting factors related to allergies, such as the Japanese cedar pollen count, were measured. McNemar's test showed that there were significantly more cough-positive patients during Asian dust periods than during the non-Asian dust period (p = 0.022). In addition, during Asian dust periods when the daily levels of Japanese cedar pollen, Japanese cypress pollen and PAHs were elevated, there were significantly more patients who experienced itchy eyes than during the non-Asian dust period (p triggers cough and allergic symptoms in adult patients with chronic cough.

  6. 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.

  7. 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.

  8. 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.

  9. Long-lasting recovery of psychotic-like symptoms in isolation-reared rats after chronic but not acute treatment with the cannabinoid antagonist AM251.

    Science.gov (United States)

    Zamberletti, Erica; Viganò, Daniela; Guidali, Cinzia; Rubino, Tiziana; Parolaro, Daniela

    2012-03-01

    In this work we investigated the ability of AM251 to reverse schizophrenia-like symptoms produced by a neurodevelopmental animal model based on a social isolation procedure. First, we assessed the validity of our isolation-rearing protocol and, as expected, isolation-reared rats showed hyperlocomotion in a novel environment, cognitive impairment in the novel object recognition (NOR) test and a significant increase in the number of aggressive behaviours in the social interaction test compared to group-housed controls. This behavioural picture was associated with a reduction in CB₁ receptor/G protein coupling in specific brain areas as well as reduced c-Fos immunoreactivity in the prefrontal cortex and caudate putamen. In this model, chronic but not acute treatment with the CB₁ receptor antagonist AM251 counteracted isolation-induced cognitive impairment in the NOR test and aggressive behaviours in the social interaction test. This behavioural recovery was accompanied by the rescue of CB₁ receptor functionality and c-Fos levels in all brain regions altered in isolation-reared rats. Moreover, chronic AM251 also increased c-Fos immunoreactivity in the nucleus accumbens, as previously demonstrated for antipsychotic drugs. Interestingly, the behavioural recovery due to chronic AM251 administration persisted until 10 d after discontinuing the treatment, indicating a long-lasting effect of the cannabinoid antagonist on psychotic-like symptoms.

  10. 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

  11. Evaluation of intranasal vaccine administration and high-dose interferon- α2b therapy for treatment of chronic upper respiratory tract infections in shelter cats.

    Science.gov (United States)

    Fenimore, Audra; Carter, Kasey; Fankhauser, Jeffrey; Hawley, Jennifer R; Lappin, Michael R

    2016-08-01

    Clinical signs of upper respiratory tract infection can be hard to manage in cats, particularly those in shelters. In this study, clinical data were collected from chronically ill (3-4 weeks' duration) cats with suspected feline herpesvirus-1 (FHV-1) or feline calicivirus (FCV) infections after administration of one of two novel therapies. Group A cats were administered a commercially available formulation of human interferon-α2b at 10,000 U/kg subcutaneously for 14 days, and group B cats were administered one dose of a FHV-1 and FCV intranasal vaccine. Molecular assays for FHV-1 and FCV were performed on pharyngeal samples, and a number of cytokines were measured in the blood of some cats. A clinical score was determined daily for 14 days, with cats that developed an acceptable response by day 14 returning to the shelter for adoption. Those failing the first treatment protocol were entered into the alternate treatment group. During the first treatment period, 8/13 cats in group A (61.5%) and all 12 cats in group B (100%) had apparent responses. The seven cats positive for nucleic acids of FHV-1 or FCV responded favorably, independent of the treatment group. There were no differences in cytokine levels between cats that responded to therapy or failed therapy. Either protocol assessed here may be beneficial in alleviating chronic clinical signs of suspected feline viral upper respiratory tract disease in some cats that have failed other, more conventional, therapies. The results of this study warrant additional research involving these protocols. PMID:26269455

  12. 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

  13. 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)

  14. 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