Visual aided pacing in respiratory maneuvers

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Rambaudi, L R [Laboratorio de Biofisica y Fisiologia ' Antonio Sadi Frumento' (Argentina); Rossi, E [Catedra de Bioingenieria II (Argentina); Mantaras, M C [Catedra de Bioingenieria II (Argentina); Perrone, M S [Laboratorio de Biofisica y Fisiologia ' Antonio Sadi Frumento' (Argentina); Siri, L Nicola [Catedra de Bioingenieria II (Argentina)

2007-11-15

A visual aid to pace self-controlled respiratory cycles in humans is presented. Respiratory manoeuvres need to be accomplished in several clinic and research procedures, among others, the studies on Heart Rate Variability. Free running respiration turns to be difficult to correlate with other physiologic variables. Because of this fact, voluntary self-control is asked from the individuals under study. Currently, an acoustic metronome is used to pace respiratory frequency, its main limitation being the impossibility to induce predetermined timing in the stages within the respiratory cycle. In the present work, visual driven self-control was provided, with separate timing for the four stages of a normal respiratory cycle. This visual metronome (ViMet) was based on a microcontroller which power-ON and -OFF an eight-LED bar, in a four-stage respiratory cycle time series handset by the operator. The precise timing is also exhibited on an alphanumeric display.

Visual aided pacing in respiratory maneuvers

International Nuclear Information System (INIS)

Rambaudi, L R; Rossi, E; Mantaras, M C; Perrone, M S; Siri, L Nicola

2007-01-01

A visual aid to pace self-controlled respiratory cycles in humans is presented. Respiratory manoeuvres need to be accomplished in several clinic and research procedures, among others, the studies on Heart Rate Variability. Free running respiration turns to be difficult to correlate with other physiologic variables. Because of this fact, voluntary self-control is asked from the individuals under study. Currently, an acoustic metronome is used to pace respiratory frequency, its main limitation being the impossibility to induce predetermined timing in the stages within the respiratory cycle. In the present work, visual driven self-control was provided, with separate timing for the four stages of a normal respiratory cycle. This visual metronome (ViMet) was based on a microcontroller which power-ON and -OFF an eight-LED bar, in a four-stage respiratory cycle time series handset by the operator. The precise timing is also exhibited on an alphanumeric display

Respiratory Viruses in Febrile Neutropenic Patients with Respiratory Symptoms

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Mohsen Meidani

2018-01-01

Full Text Available Background: Respiratory infections are a frequent cause of fever in neutropenic patients, whereas respiratory viral infections are not frequently considered as a diagnosis, which causes high morbidity and mortality in these patients. Materials and Methods: This prospective study was performed on 36 patients with neutropenia who admitted to hospital were eligible for inclusion with fever (single temperature of >38.3°C or a sustained temperature of >38°C for more than 1 h, upper and lower respiratory symptoms. Sampling was performed from the throat of the patient by the sterile swab. All materials were analyzed by quantitative real-time multiplex polymerase chain reaction covering the following viruses; influenza, parainfluenza virus (PIV, rhinovirus (RV, human metapneumovirus, and respiratory syncytial virus (RSV. Results: RV was the most frequently detected virus and then RSV was the most. PIV was not present in any of the tested samples. Furthermore, no substantial differences in the distribution of specific viral species were observed based on age, sex, neutropenia duration, hematological disorder, and respiratory tract symptoms and signs (P > 0.05. Conclusion: Our prospective study supports the hypothesis that respiratory viruses play an important role in the development of neutropenic fever, and thus has the potential to individualize infection treatment and to reduce the extensive use of antibiotics in immunocompromised patients with neutropenia.

Seronegative neuromyelitis optica presenting with life-threatening respiratory failure.

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Nardone, Raffaele; Zuccoli, Giulio; Brigo, Francesco; Trinka, Eugen; Fitzgerald, Ryan T

2016-11-01

Dyspnea has rarely been reported as a presenting symptom in patients with neuromyelitis optica (NMO). We report an unusual case of NMO relapse presenting with rapidly progressive respiratory failure and briefly discuss the possible pathophysiological mechanisms of this potential life-threatening complication of NMO. The 58-year-old woman with a history of bilateral optic neuritis presented to the emergency department with rapidly worsening dyspnea. Cervical spine magnetic resonance imaging showed extensive abnormal signal with involvement of the medulla oblongata. Since in our patient chest radiography failed to disclose a diaphragmatic palsy that is commonly observed in patients with phrenic nerve involvement, this acute manifestation of the disease may be attributed to brainstem involvement instead of cervical myelitis. Clinicians should be aware of this atypical presentation of NMO, which needs to be promptly recognized and aggressively treated.

Respiratory Tract Infections in Diabetic and Non-Diabetic Individuals are Linked with Serum Surfactant Protein-D

International Nuclear Information System (INIS)

Jawed, S.; Parveen, N.

2015-01-01

Objective: To find out the rate of respiratory tract infections in diabetic and non-diabetic individuals and their relation with surfactant protein D. Methods: The cross-sectional study was conducted at Dow University of Health Sciences, Karachi, from September 2011 to April 2012, and comprised subjects of both genders between ages of 30 and 60 years. The subjects were divided into four groups: diabetic obese, non-diabetic obese, diabetic non-obese, and non-diabetic-non-obese. A structured questionnaire was used to collect information about respiratory tract infections. Serum surfactant protein D levels were analysed using human surfactant protein D enzyme-linked immunosorbent assay kit. Statistical analysis was performed using SPSS 16. Results: Of the 90 subjects, there were 20(22.2 percent) diabetic obese, 30(33.3 percent) non-diabetic obese, 10(11.1 percent) diabetic non-obese, and 30(33.3 percent) non-diabetic-non-obese. The overall mean age was 36.6±103 years. Among the diabetic obese, 15(75 percent) had respiratory tract infections which was higher than the other study groups, and patients having respiratory tract infections had lower surfactant protein D levels than those who did not have infections (p=0.01). Conclusion: Diabetic obese subjects had greater rate of recurrent respiratory tract infections and had lower concentration of serum surfactant protein D compared to subjects without respiratory tract infections. (author)

Contributions of individual acculturation and neighborhood ethnic density to variations in Hispanic children's respiratory health in a US-Mexican border metropolis.

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Grineski, Sara E; Collins, Timothy W; Kim, Young-An

2016-09-01

We used an expanded conceptualization of ethnic density at the neighborhood level, tailored to Hispanic majority communities in the USA, and a robust measure of children's acculturation at the individual level, to predict Hispanic children's respiratory health. We conducted a cross-sectional survey of 1904 children in 2012 in El Paso, TX, USA. One thousand one hundred and seven Hispanic children nested within 72 census tracts were analyzed. Multilevel logistic regression models with cross-level interactions were used to predict bronchitis, asthma and wheezing during sleep. A neighborhood-level ethnic density factor was a non-significant risk factor while individual-level acculturation was a significant risk factor for the three outcomes. Pest troubles and not having been breastfed as an infant intensified the positive association between ethnic density and bronchitis. Increases in ethnic density intensified the odds of wheezing in sleep if the child was not low birth weight or was not economically deprived. Results suggest that increasing individual-level acculturation is detrimental for US Hispanic children's respiratory health in this Hispanic majority setting, while high ethnic density neighborhoods are mildly risky and pose more significant threats when other individual-level factors are present. © The Author 2015. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Increased plasma soluble uPAR level is a risk marker of respiratory cancer in initially cancer-free individuals

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Langkilde, Anne A; Hansen, Tine Willum; Ladelund, Steen

2011-01-01

BACKGROUND: Soluble urokinase plasminogen activator receptor (suPAR) is a stable plasma biomarker associated with inflammation and disease. This study tested the association between suPAR levels and incident respiratory, gastrointestinal or other types of cancer in initially cancer-free individuals...... with respiratory, gastrointestinal and other cancer types, respectively.CONCLUSIONS: Elevated suPAR levels were associated with increased risk of incident respiratory cancer and other types of cancer, but not gastrointestinal cancers, independently of established risk factors, CRP and leukocyte numbers. Impact.......RESULTS: suPAR levels ranged from 0.6-22 ng/ml, and median suPAR level was 4.01 ng/ml. 1 ng/ml increase in baseline suPAR was associated with adjusted hazard ratios (HR) of 1.61 (95% CI: 1.23-2.11, P

Clinical Presentation and Birth Outcomes Associated with Respiratory Syncytial Virus Infection in Pregnancy.

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Helen Y Chu

Full Text Available Respiratory syncytial virus (RSV is the most important cause of viral pneumonia in children worldwide. A maternal vaccine may protect both the mother and infant from RSV illness. The epidemiology and clinical presentation of RSV in pregnant and postpartum women is not well-described.Data were collected from a prospective, randomized trial of influenza immunization in pregnant women in rural southern Nepal. Women were enrolled in their second trimester of pregnancy and followed until six months postpartum. Active weekly home-based surveillance for febrile respiratory illness was performed. Mid-nasal swabs collected with episodes of respiratory illness were tested for RSV by real-time polymerase chain reaction.RSV was detected in 14 (0.4% illness episodes in 3693 women over 3554 person-years of surveillance from 2011-2014. RSV incidence was 3.9/1000 person-years overall, and 11.8/1000 person-years between September and December. Seven (50% women sought care for RSV illness; none died. Of the 7 (50% illness episodes during pregnancy, all had live births with 2 (29% preterm births and a median birthweight of 3060 grams. This compares to 469 (13% preterm births and a median birthweight of 2790 grams in women without RSV during pregnancy. Of the 7 mothers with postpartum RSV infection, RSV was detected in 4 (57% of their infants.RSV was an uncommon cause of febrile respiratory illness in mothers during pregnancy in Nepal. These data will inform prevention and therapeutic strategies against RSV in resource-limited settings.

Cytokine patterns in paediatric patients presenting serious gastrointestinal and respiratory bacterial infections

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Palacios-Martínez, Monika; Rodríguez-Cruz, Leonor; Cortés-Bejar, Consuelo Del Carmen; Valencia-Chavarría, Fernando; Martínez-Gómez, Daniel; González-Torres, María Cristina

2014-01-01

In the adaptive immune response, the types of cytokines produced define whether there is a cellular (T1) or a humoral (T2) response. Specifically, in the T1 response, interleukin 2 (IL-2), interferon γ (IFN-γ) and tumor necrosis factor β (TNF-β) are produced, whereas in the T2 response, IL-4, IL-5, IL- 6, IL-10 and IL-13 are primarily produced. Cytokines are primarily involved in the regulation of immune system cells. The aim of the present study was to evaluate the cytokine patterns (Type 1/Type 2) and TNF-α expression levels in children with severe gastrointestinal and respiratory bacterial infections. The enzyme-linked immunosorbent assay (ELISA) technique was used to identify the cytokines and the infectious agents. The results obtained demonstrated that, in general, children with bacterial infections experienced an increase in IL-2, IFN-γ and IL-4 concentrations and a decrease in TNF-α, IL-5 and IL-6 concentrations when compared to healthy children. Specifically, type 1 cytokines and an increased TNF-α concentration were found in children with gastrointestinal infections. However, patients with respiratory infections showed increased concentrations of both T2 (IL-4, IL-6 and IL-10) and T1 (IL-2 and IFN-γ) components. Thus, it was concluded that children with gastrointestinal infections exclusively developed a T1 response, whereas children with respiratory infections developed a T1/T2 response to fight the infection. PMID:26155128

Effect of respiratory muscle training on exercise performance in healthy individuals: a systematic review and meta-analysis.

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Illi, Sabine K; Held, Ulrike; Frank, Irène; Spengler, Christina M

2012-08-01

Two distinct types of specific respiratory muscle training (RMT), i.e. respiratory muscle strength (resistive/threshold) and endurance (hyperpnoea) training, have been established to improve the endurance performance of healthy individuals. We performed a systematic review and meta-analysis in order to determine the factors that affect the change in endurance performance after RMT in healthy subjects. A computerized search was performed without language restriction in MEDLINE, EMBASE and CINAHL and references of original studies and reviews were searched for further relevant studies. RMT studies with healthy individuals assessing changes in endurance exercise performance by maximal tests (constant load, time trial, intermittent incremental, conventional [non-intermittent] incremental) were screened and abstracted by two independent investigators. A multiple linear regression model was used to identify effects of subjects' fitness, type of RMT (inspiratory or combined inspiratory/expiratory muscle strength training, respiratory muscle endurance training), type of exercise test, test duration and type of sport (rowing, running, swimming, cycling) on changes in performance after RMT. In addition, a meta-analysis was performed to determine the effect of RMT on endurance performance in those studies providing the necessary data. The multiple linear regression analysis including 46 original studies revealed that less fit subjects benefit more from RMT than highly trained athletes (6.0% per 10 mL · kg⁻¹ · min⁻¹ decrease in maximal oxygen uptake, 95% confidence interval [CI] 1.8, 10.2%; p = 0.005) and that improvements do not differ significantly between inspiratory muscle strength and respiratory muscle endurance training (p = 0.208), while combined inspiratory and expiratory muscle strength training seems to be superior in improving performance, although based on only 6 studies (+12.8% compared with inspiratory muscle strength training, 95% CI 3

Dynamics of human respiratory system mycoflora

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Anna Biedunkiewicz

2014-08-01

Full Text Available The study aimed at determing the prevalence of individual species of fungi in the respiratory systems of women and men, analysis of the dynamics of the fungi in individual sections of the respiratory system as concerns their quantity and identification of phenology of the isolated fungi coupled with an attempt at identifying their possible preferences for appearing during specific seasons of thc year. During 10 years of studies (1989- 1998. 29 species of fungi belonging: Candida, Geolrichum, Saccharomyces, Saccharomycopsis, Schizosaccharomyces, Torulopsis, Trichosporon and Aspergillus were isolated from the ontocenoses of the respiratory systems of patients at the Independent Public Center for Pulmonology and Oncology in Olsztyn. Candida albicans was a clearly dominating fungus. Individual species appeared individually, in twos or threes in a single patient, they were isolated more frequently in the spring and autumn, less frequently during the winter and summer. The largest number of fungi species were isolated from sputum (29 species, bronchoscopic material (23 species and pharyngeal swabs (15 species. Sacchoromycopsis capsularis and Trichosporon beigelii should be treated as new for the respiratory system. Biodiversity of fungi, their numbers and continous fluctuations in frequency indicate that the respiratory system ontocenose offers the optimum conditions for growth and development of the majority of the majority of yeasts - like fungi.

Inclusion Body Myositis: A Case Presenting with Respiratory Failure and Autopsy Findings Leading to the Hypothesis of a Paraneoplastic Cause.

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Dardis, Christopher; Antezana, Ariel; Tanji, Kurenai; Maccabee, Paul J

2017-06-23

BACKGROUND Sporadic inclusion body myositis (IBM) is the most common acquired myopathy seen in adults aged over 50 years, with a prevalence estimated at between 1 and 70 per million. Weakness of the diaphragm with loss of vital capacity is almost universal in IBM. This is almost always asymptomatic. When respiratory complications occur, they are most often due to aspiration. Respiratory failure due to diaphragmatic weakness is exceptionally rare, particularly as the presenting symptom of the disease. It is not currently considered to be a paraneoplastic syndrome. CASE REPORT Our patient presented with hypercarbic respiratory failure. This is the first such reported case without signs of weakness elsewhere of which we are aware. We suspected IBM based on her history of progressive weakness and findings on electromyography. There was a delay of 5 years in obtaining biopsy for confirmation, during which she presented with recurrent episodes of respiratory failure despite using non-invasive ventilation. An autopsy revealed the presence of papillary thyroid carcinoma with spread to local lymph nodes. On the basis that these co-morbidities are unlikely to have occurred by chance (we estimate 1×10-17), we hypothesize that IBM may be a paraneoplastic condition. We acknowledge that proof would require demonstrating a pathogenic antibody. CONCLUSIONS IBM should be considered in older patients (age >45) presenting with otherwise unexplained respiratory failure. A workup for possible malignancy in this setting appears reasonable.

Respiratory risks in broiler production workers

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M do CB de Alencar

2004-03-01

Full Text Available There are many situations that involve health risks to the Brazilian rural worker, and animal production is just one of them. Inhalation of organic dust, which has many microorganisms, leads in general to respiratory allergic reactions in some individuals, "asthma-like syndrome", and mucous membrane inflammation syndrome, that is a complex of nasal, eye, and throat complaints. Furthermore, workers might have farmer's hypersensitivity pneumonia, that is a respiratory health risk along the years. The objective of this study was to evaluate the potential pulmonary health risks in poultry production workers in the region of Curitiba, PR, Brazil. Interviews using a pre-elaborated questionnaire with 40 questions were made with 37 broiler production workers, which were submitted to a pulmonary function test. Results of restrictive function with lower FEV1 (the maximum respiratory potential, the forced expiratory volume in the first second of exhalation and FVC (forced vital capacity represented 24.32% of the total of workers, and severe obstruction represented 2.70%. Other symptoms were found in 67.57% of the workers as well. The results showed that those who work more than 4 years and within more than one poultry house, exceeding 5 hours per day of work, presented higher pulmonary health risks. It is concluded that the activities within broiler houses may induce allergic respiratory reaction in workers. The use of IPE (individual protection equipment besides special attention to the air quality inside the housing may be advised in a preventive way.

Two cases of rickets presenting with poor growth, hypotonia, and respiratory problems.

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Wouters, E; Wojciechowski, M; de Vries, E

2015-06-01

Rickets is a rare disease in developed countries. In children, it is a disease which affects growing bone. Depending on the severity, it can present with a wide variety of symptoms. Because it is such a rare disease in developed countries, symptoms suggesting rickets are often not easily recognized. This can cause a delay in diagnosing and treating rickets. Often unnecessary and sometimes invasive investigations are performed. First leading clues to rickets on physical examination are poor growth, especially length, thickening of wrists, bow legs, and craniotabes. At further examination, special attention should be paid to osteopenia and cupping and fraying at the metaphyses on X-rays. Laboratory results suggestive for rickets are elevated alkaline phosphatase and disturbances in calcium and phosphate homeostasis. In this report, we present two cases presenting with poor growth, severe pain, and respiratory problems secondary to calcipenic rickets.

Silent gastro-esophageal reflux in children presenting with recurrent lower respiratory tract infections

International Nuclear Information System (INIS)

Thomas, E.J.; Bharathi Dasan, J.; Kumar, R.; Chanderashekher, N.; Tripathi, M.; Kabra, S.K.; Malhotra, A.; Kumar, A.; Menon, S.

2002-01-01

Introduction: Paediatric respiratory tract infections are one of the most common reasons for physician visits and hospitalisation, and are associated with significant morbidity and mortality. The socioeconomic impact of these recurrent infections is staggering. Gastroesophageal reflux (GER) has long been associated with pulmonary symptoms and diseases. Aims: The present retrospective analysis was undertaken to find out the incidence of GER in children suffering from recurrent lower respiratory tract infections without any typical gastrointestinal (GI) symptoms of GER. Materials and Methods: A total of 297 children with a mean age of 2.7 years and range 9-months to 8 years were evaluated. All studies were performed using a dose of 100-200 micro Curie (3.7-7.4MBq) of Tc99m-sulphur colloid, which was administered via a nasogastric tube into the stomach in younger children. Adequate intragastric volume was ensured by instilling water of 50-ml volume for children less than 6 months and 100-ml volume for children between 6-12 months of age. The nasogastric tube was removed with the patient held in erect position and a small volume of water was pushed to avoid any contamination. In older children the isotope was administered in a capsule and was swallowed with 150-300 ml of water. Results: Of the total 297 children, 111(37%) children had GER on scintigraphy. Conclusion: There is a high incidence of silent GER in children suffering from recurrent lower respiratory tract infections. Scintiscanning can be used as a screening modality in these children

A dynamic population-based model for the development of work-related respiratory health effects among bakery workers.

NARCIS (Netherlands)

Warren, N.; Meijster, T.; Heederik, D.; Tielemans, E.

2009-01-01

OBJECTIVES: This paper presents a dynamic population-based model for the development of sensitisation and respiratory symptoms in bakery workers. The model simulates a population of individual workers longitudinally and tracks the development of work-related sensitisation and respiratory symptoms in

A dynamic population-based model for the development of work-related respiratory health effects among bakery workers

NARCIS (Netherlands)

Warren, N.; Meijster, T.; Heederik, D.; Tielemans, E.

2009-01-01

Objectives: This paper presents a dynamic population-based model for the development of sensitisation and respiratory symptoms in bakery workers. The model simulates a population of individual workers longitudinally and tracks the development of work-related sensitisation and respiratory symptoms in

Potential impact of fireworks on respiratory health

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Gouder, Caroline; Montefort, Stephen

2014-01-01

The world-wide use of fireworks with their consequent detrimental effect on the air quality is widely recognized with elevated ambient air levels of particulate matter and its several metallic components and gases identified in several studies carried out during such events. Exposed individuals may be at risk following inhalation of such produced pollutants. This review focuses on the impact of fireworks on air quality and the potential effect of fireworks on the respiratory system of healthy individuals as well as those suffering from underlying respiratory diseases, particularly asthma and chronic obstructive pulmonary disease (COPD). This applies not only to spectators including children but also to pyrotechnicians themselves. An extensive Medline search revealed that a strong evidence of the impact of fireworks on respiratory health is lacking in susceptible as well as healthy individuals with no formal studies on COPD or asthma, other than a few case reports in the latter. The implementation of global strategies to control the use of fireworks and hence improve air quality could possibly reduce their likely detrimental effect on human respiratory health in exposed individuals, but clearly a more targeted research is needed. PMID:25378846

Respiratory Phenotypes for Preterm Infants, Children, and Adults: Bronchopulmonary Dysplasia and More.

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Collaco, Joseph M; McGrath-Morrow, Sharon A

2018-05-01

Ongoing advancements in neonatal care since the late 1980s have led to increased numbers of premature infants surviving well beyond the neonatal period. As a result of increased survival, many individuals born preterm manifest chronic respiratory symptoms throughout infancy, childhood, and adult life. The archetypical respiratory disease of prematurity, bronchopulmonary dysplasia, is the second most common chronic pediatric respiratory disease after asthma. However, there are several commonly held misconceptions. These misconceptions include that bronchopulmonary dysplasia is rare, that bronchopulmonary dysplasia resolves within the first few years of life, and that bronchopulmonary dysplasia does not impact respiratory health in adult life. This focused review describes a spectrum of respiratory conditions that individuals born prematurely may experience throughout their lifespan. Specifically, this review provides quantitative estimates of the number of individuals with alveolar, airway, and vascular phenotypes associated with bronchopulmonary dysplasia, as well as non-bronchopulmonary dysplasia respiratory phenotypes such as airway malacia, obstructive sleep apnea, and control of breathing issues. Furthermore, this review illustrates what is known about the potential for progression and/or lack of resolution of these respiratory phenotypes in childhood and adult life. Recognizing the spectrum of respiratory phenotypes associated with individuals born preterm and providing comprehensive and personalized care to these individuals may help to modulate adverse respiratory outcomes in later life.

Longitudinal modelling of respiratory symptoms in children

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Schlink, Uwe; Fritz, Gisela; Herbarth, Olf; Richter, Matthias

2002-08-01

A panel of 277 children, aged 3-7 years, was used to study the association between air pollution (O3, SO2, NO2, and total suspended particles), meteorological factors (global radiation, maximum daytime temperature, daily averages of vapour pressure and air humidity) and respiratory symptoms. For 759 days the symptoms were recorded in a diary and modelling was based on a modification of the method proposed by Korn and Whittemore (Biometrics 35: 795-798, 1979). This approach (1) comprises an extension using environmental parameters at different time scales, (2) addresses the suitability of using the daily fraction of symptomatic individuals to account for inter-individual interactions and (3) enables the most significant weather effects to be identified. The resulting model consisted of (1) an individual specific intercept that takes account of the population's heterogeneity, (2) the individual's health status the day before, (3) a long-term meteorological effect, which may be either the squared temperature or global radiation in interaction with temperature, (4) the short-term effect of sulfur dioxide, and (5) the short-term effect of an 8-h ozone concentration above 60 µg/m3. Using the estimated parameters as input to a simulation study, we checked the quality of the model and demonstrate that the annual cycle of the prevalence of respiratory symptoms is associated to atmospheric covariates. Individuals suffering from allergy have been identified as a group of a particular susceptibility to ozone. The duration of respiratory symptoms appears to be free of scale and follows an exponential distribution function, which confirms that the symptom record of each individual follows a Poisson point-process. This supports the assumption that not only respiratory diseases, but also respiratory symptoms can be considered an independent measure for the health status of a population sample. Since a point process is described by only one parameter (namely the intensity of the

Individuals with Metabolically Healthy Overweight/Obesity Have Higher Fat Utilization than Metabolically Unhealthy Individuals

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Arturo Pujia

2016-01-01

Full Text Available The mechanisms underlying the change in phenotype from metabolically healthy to metabolically unhealthy obesity are still unclear. The aim of this study is to investigate whether a difference in fasting fat utilization exists between overweight/obese individuals with a favorable cardiovascular risk profile and those with Metabolic Syndrome and Type 2 diabetes. Furthermore, we sought to explore whether there is an association between fasting fat utilization and insulin resistance. In this cross-sectional study, 172 overweight/obese individuals underwent a nutritional assessment. Those with fasting glucose ≥126 mg/dL or antidiabetic treatment were considered to be diabetics. If at least three of the NCEP criteria were present, they had Metabolic Syndrome, while those with less criteria were considered to be healthy overweight/obese. An indirect calorimetry was performed to estimate Respiratory Quotient, an index of nutrient utilization. A lower Respiratory Quotient (i.e., higher fat utilization was found in healthy overweight/obese individuals than in those with Metabolic Syndrome and Type 2 diabetes (0.85 ± 0.05; 0.87 ± 0.06; 0.88 ± 0.05 respectively, p = 0.04. The univariate and multivariable analysis showed a positive association between the Respiratory Quotient and HOMA-IR (slope in statistic (B = 0.004; β = 0.42; p = 0.005; 95% Confidence interval = 0.001–0.006. In this study, we find, for the first time, that the fasting Respiratory Quotient is significantly lower (fat utilization is higher in individuals who are metabolically healthy overweight/obese than in those with metabolically unhealthy obesity. In addition, we demonstrated the association between fat utilization and HOMA-IR, an insulin resistance index.

Psychological profile of individuals presenting with chronic cough

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Katrin Hulme

2017-03-01

Full Text Available Chronic refractory cough (CRC is a common problem in respiratory clinics. Adverse effects on quality of life are documented in the literature, but relatively little is known about the underlying psychological factors in this patient population. We aimed to investigate the association of psychological factors with chronic cough, comparing CRC to explained cough and non-cough groups. 67 patients attending a specialist cough clinic (CRC, n=25; explained cough, n=42 and 22 non-cough individuals participated. All participants completed the Hospital Anxiety & Depression Scale, Big Five Inventory (Personality, Chalder Fatigue Scale and Patient Health Questionnaire-15. Cough patients also completed the Illness Perception Questionnaire-Revised. Appropriate statistical analyses were used to compare participant groups. Chronic refractory coughers displayed significantly higher levels of anxiety, depression, fatigue and somatic physical symptoms than non-cough participants. Compared to explained coughers, there were higher depression and fatigue scores and significantly more negative illness representations (specifically, strong beliefs regarding negative consequences, lower illness coherence and higher emotional representations. “Explained” coughers reported significantly increased fatigue and somatic symptoms in comparison to non-coughers. The prevalence of fatigue, low mood, negative illness beliefs and increased physical symptom reporting should be considered in consultations and in developing novel interventions for CRC patients.

Vitamin D supplementation to prevent acute respiratory tract infections: systematic review and meta-analysis of individual participant data.

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Martineau, Adrian R; Jolliffe, David A; Hooper, Richard L; Greenberg, Lauren; Aloia, John F; Bergman, Peter; Dubnov-Raz, Gal; Esposito, Susanna; Ganmaa, Davaasambuu; Ginde, Adit A; Goodall, Emma C; Grant, Cameron C; Griffiths, Christopher J; Janssens, Wim; Laaksi, Ilkka; Manaseki-Holland, Semira; Mauger, David; Murdoch, David R; Neale, Rachel; Rees, Judy R; Simpson, Steve; Stelmach, Iwona; Kumar, Geeta Trilok; Urashima, Mitsuyoshi; Camargo, Carlos A

2017-02-15

Objectives  To assess the overall effect of vitamin D supplementation on risk of acute respiratory tract infection, and to identify factors modifying this effect. Design  Systematic review and meta-analysis of individual participant data (IPD) from randomised controlled trials. Data sources  Medline, Embase, the Cochrane Central Register of Controlled Trials, Web of Science, ClinicalTrials.gov, and the International Standard Randomised Controlled Trials Number registry from inception to December 2015. Eligibility criteria for study selection  Randomised, double blind, placebo controlled trials of supplementation with vitamin D 3 or vitamin D 2 of any duration were eligible for inclusion if they had been approved by a research ethics committee and if data on incidence of acute respiratory tract infection were collected prospectively and prespecified as an efficacy outcome. Results  25 eligible randomised controlled trials (total 11 321 participants, aged 0 to 95 years) were identified. IPD were obtained for 10 933 (96.6%) participants. Vitamin D supplementation reduced the risk of acute respiratory tract infection among all participants (adjusted odds ratio 0.88, 95% confidence interval 0.81 to 0.96; P for heterogeneity acute respiratory tract infection overall. Patients who were very vitamin D deficient and those not receiving bolus doses experienced the most benefit. Systematic review registration  PROSPERO CRD42014013953. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

The effects of individually ventilated cages on the respiratory systems of male and female Wistar rats from birth until adulthood

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Guilherme D’Aprile Marchesi

Full Text Available OBJECTIVE: To evaluate the respiratory systems of male and female rats maintained in individually ventilated cages (IVCs from birth until adulthood. METHODS: Female Wistar rats were housed in individually ventilated cages or conventional cages (CCs and mated with male Wistar rats. After birth and weaning, the male offspring were separated from the females and kept in cages of the same type until 12 weeks of age. RESULTS: The level of food consumption was lower in male offspring (IVC=171.7±9; CC=193.1±20 than in female offspring (IVC=100.6±7; CC=123.4±0.4, whereas the water intake was higher in female offspring (IVC=149.8±11; CC=99.2±0 than in male offspring (IVC=302.5±25; CC=249.7±22 at 11 weeks of age when housed in IVCs. The cage temperature was higher in individually ventilated cages than in conventional cages for both male (IVCs=25.9±0.5; CCs=22.95±0.3 and female (IVCs=26.2±0.3; CCs=23.1±0.3 offspring. The respiratory resistance (IVC=68.8±2.8; CC=50.6±3.0 and elastance (IVC=42.0±3.9; CC=32.4±2.0 at 300 µm/kg were higher in the female offspring housed in ventilated cages. The ciliary beat values were lower in both the male (IVCs=13.4±0.2; CC=15±0.4 and female (IVC=13.5±0.4; CC=15.9±0.6 offspring housed in individually ventilated cages than in those housed in conventional cages. The total cell (IVC=117.5±9.7; CC=285.0±22.8, neutrophil (IVC=13.1±4.8; CC=75.6±4.1 and macrophage (IVC=95.2±11.8; CC=170.0±18.8 counts in the bronchoalveolar lavage fluid were lower in the female offspring housed in individually ventilated cages than in those housed in conventional cages. CONCLUSIONS: The environmental conditions that exist in individually ventilated cages should be considered when interpreting the results of studies involving laboratory animals. In this study, we observed gender dimorphism in both the water consumption and respiratory mechanics of rats kept in ventilated cages.

The effects of individually ventilated cages on the respiratory systems of male and female Wistar rats from birth until adulthood

Science.gov (United States)

Marchesi, Guilherme D’Aprile; de Fatima Soto, Sônia; de Castro, Isac; Rodrigues, Thiago Guimarães; Moriya, Henrique Takachi; de Almeida, Francine Maria; Pazetti, Rogerio; Heimann, Joel Claudio; Furukawa, Luzia Naôko Shinohara

2017-01-01

OBJECTIVE: To evaluate the respiratory systems of male and female rats maintained in individually ventilated cages (IVCs) from birth until adulthood. METHODS: Female Wistar rats were housed in individually ventilated cages or conventional cages (CCs) and mated with male Wistar rats. After birth and weaning, the male offspring were separated from the females and kept in cages of the same type until 12 weeks of age. RESULTS: The level of food consumption was lower in male offspring (IVC=171.7±9; CC=193.1±20) than in female offspring (IVC=100.6±7; CC=123.4±0.4), whereas the water intake was higher in female offspring (IVC=149.8±11; CC=99.2±0) than in male offspring (IVC=302.5±25; CC=249.7±22) at 11 weeks of age when housed in IVCs. The cage temperature was higher in individually ventilated cages than in conventional cages for both male (IVCs=25.9±0.5; CCs=22.95±0.3) and female (IVCs=26.2±0.3; CCs=23.1±0.3) offspring. The respiratory resistance (IVC=68.8±2.8; CC=50.6±3.0) and elastance (IVC=42.0±3.9; CC=32.4±2.0) at 300 µm/kg were higher in the female offspring housed in ventilated cages. The ciliary beat values were lower in both the male (IVCs=13.4±0.2; CC=15±0.4) and female (IVC=13.5±0.4; CC=15.9±0.6) offspring housed in individually ventilated cages than in those housed in conventional cages. The total cell (IVC=117.5±9.7; CC=285.0±22.8), neutrophil (IVC=13.1±4.8; CC=75.6±4.1) and macrophage (IVC=95.2±11.8; CC=170.0±18.8) counts in the bronchoalveolar lavage fluid were lower in the female offspring housed in individually ventilated cages than in those housed in conventional cages. CONCLUSIONS: The environmental conditions that exist in individually ventilated cages should be considered when interpreting the results of studies involving laboratory animals. In this study, we observed gender dimorphism in both the water consumption and respiratory mechanics of rats kept in ventilated cages. PMID:28355363

Childhood respiratory illness presentation and service utilisation in primary care: a six-year cohort study in Wellington, New Zealand, using natural language processing (NLP) software.

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Dowell, Anthony; Darlow, Ben; Macrae, Jayden; Stubbe, Maria; Turner, Nikki; McBain, Lynn

2017-08-01

To identify childhood respiratory tract-related illness presentation rates and service utilisation in primary care by interrogating free text and coded data from electronic medical records. Retrospective cohort study. Data interrogation used a natural language processing software inference algorithm. 36 primary care practices in New Zealand. Data analysed from January 2008 to December 2013. The records from 77 582 children enrolled were reviewed over a 6-year period to estimate the presentation of childhood respiratory illness and service utilisation. This cohort represents 268 919 person-years of data and over 650 000 unique consultations. Childhood respiratory illness presentation rate to primary care practice, with description of seasonal and yearly variation. Respiratory conditions constituted 46% of all child-general practitioner consultations with a stable year-on-year pattern of seasonal peaks. Upper respiratory tract infection was the most common respiratory category accounting for 21.0% of all childhood consultations, followed by otitis media (12.2%), wheeze-related illness (9.7%), throat infection (7.4%) and lower respiratory tract infection (4.4%). Almost 70% of children presented to their general practitioner with at least one respiratory condition in their first year of life; this reduced to approximately 25% for children aged 10-17. This is the first study to assess the primary care incidence and service utilisation of childhood respiratory illness in a large primary care cohort by interrogating electronic medical record free text. The study identified the very high primary care workload related to childhood respiratory illness, especially during the first 2 years of life. These data can enable more effective planning of health service delivery. The findings and methodology have relevance to many countries, and the use of primary care 'big data' in this way can be applied to other health conditions. © Article author(s) (or their employer

The trachea in children with respiratory diseases including children presenting as cot deaths.

OpenAIRE

Wailoo, M; Emery, J L

1980-01-01

The tracheas of 74 children with respiratory disorders were analysed and compared with the tracheas of children with no respiratory symptoms. The test tracheas showed an increase in the size of the lumen and the length of the cartilage and membrane, the increase in the length of membrane being particularly striking. The relation between age at onset and duration of symptoms was uncertain.

High prevalence of common respiratory viruses and no evidence of Middle East respiratory syndrome coronavirus in Hajj pilgrims returning to Ghana, 2013.

Science.gov (United States)

Annan, Augustina; Owusu, Michael; Marfo, Kwadwo Sarfo; Larbi, Richard; Sarpong, Francisca Naana; Adu-Sarkodie, Yaw; Amankwa, Joseph; Fiafemetsi, Samuel; Drosten, Christian; Owusu-Dabo, Ellis; Eckerle, Isabella

2015-06-01

The Middle East respiratory syndrome coronavirus (MERS-CoV) emerged in 2012 on the Arabian Peninsula and has caused severe respiratory disease with more than 800 laboratory-confirmed cases. The return of infected pilgrims to their home countries with a putative spread of MERS-CoV necessitates further surveillance. A cross sectional study of 839 adult African Hajj pilgrims returning to Accra in Ghana, West Africa, was conducted in 2013 to assess the prevalence of respiratory symptoms as well as of MERS-CoV, human rhinovirus (HRV), respiratory syncytial virus (RSV) and influenza A virus (FLU A) infection. Six hundred and fifty-one (77.6%) pilgrims had respiratory symptoms. Tests were positive for at least one of the viruses other than MERS-CoV in 179 (21.3%) of all pilgrims, with 22.4% detection in symptomatic vs. 17.6% detection in asymptomatic pilgrims. No MERS-CoV was detected, although common respiratory viruses were prevalent, with positive findings for HRV in 141 individuals (16.8%), RSV in 43 individuals (5.1%) and FLU A in 11 individuals (1.3%). Results were positive for more than one virus in 16 (1.9%) individuals, including 14 (1.7%) RSV/HRV co-infections and 2 (0.2%) FLU A/HRV co-infections. A total 146 (22.4%) of the symptomatic returnees tested positive for at least one respiratory virus compared with 33 (17.6%) of the asymptomatic pilgrims who had at least one detectable virus in their sample. The prevalence of viral respiratory infections among Hajj pilgrims in both symptomatic and asymptomatic subjects was high. Although it is reassuring that MERS-CoV was not detected in the tested population, there is a need for active surveillance of Hajj pilgrims. © 2015 John Wiley & Sons Ltd.

Factors associated with abnormal spirometry among HIV-infected individuals.

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Drummond, M Bradley; Huang, Laurence; Diaz, Philip T; Kirk, Gregory D; Kleerup, Eric C; Morris, Alison; Rom, William; Weiden, Michael D; Zhao, Enxu; Thompson, Bruce; Crothers, Kristina

2015-08-24

HIV-infected individuals are susceptible to development of chronic lung diseases, but little is known regarding the prevalence and risk factors associated with different spirometric abnormalities in this population. We sought to determine the prevalence, risk factors and performance characteristics of risk factors for spirometric abnormalities among HIV-infected individuals. Cross-sectional cohort study. We analyzed cross-sectional US data from the NHLBI-funded Lung-HIV consortium - a multicenter observational study of heterogeneous groups of HIV-infected participants in diverse geographic sites. Logistic regression analysis was performed to determine factors statistically significantly associated with spirometry patterns. A total of 908 HIV-infected individuals were included. The median age of the cohort was 50 years, 78% were men and 68% current smokers. An abnormal spirometry pattern was present in 37% of the cohort: 27% had obstructed and 10% had restricted spirometry patterns. Overall, age, smoking status and intensity, history of Pneumocystis infection, asthma diagnosis and presence of respiratory symptoms were independently associated with an abnormal spirometry pattern. Regardless of the presence of respiratory symptoms, five HIV-infected participants would need to be screened with spirometry to diagnose two individuals with any abnormal spirometry pattern. Nearly 40% of a diverse US cohort of HIV-infected individuals had an abnormal spirometry pattern. Specific characteristics including age, smoking status, respiratory infection history and respiratory symptoms can identify those at risk for abnormal spirometry. The high prevalence of abnormal spirometry and the poor predictive capability of respiratory symptoms to identify abnormal spirometry should prompt clinicians to consider screening spirometry in HIV-infected populations.

Comparison of respiratory functions of athletes engaged in different individual sports branches

Directory of Open Access Journals (Sweden)

Tülin Atan

2013-01-01

Full Text Available Objectives: It was aimed to research pulmonary functionsof sedentary males and athletes who engaged in differentindividual sports branches in the same age group.Methods: 50 male athletes in 15-16 age group in the starcategory participated from each of the branches of judo,athletics, wrestling, taekwondo, table tennis and swimmingand 50 sedentary males participated as well; beingin total 350 subjects. Among respiratory functions tests;vital capacity (VC, forced vital capacity (FVC and maximumvoluntary ventilation (MVV values were measured.Results were compared.Results: As a result of measurement, VC values of wrestlers,swimmer and taekwondo athletes were significantlyhigher than the values of sedentary males in statisticalsize (p<0.05 and p<0.01. VC values of swimmers weresignificantly higher than athletes of judo, track and fieldand table tennis athletes (p<0.01. It was determinedthat FVC and FEV1 values of swimmers and wrestlershave significantly higher values than sedentary subjects(p<0.05. FVIC values of swimmers were significantlyhigher than athletes, table tennis players and sedanters(p<0.05 and p<0.01. MVV values of swimmers were significantlyhigher than judo, track and field and table tennisathletes (p<0.05. When the respiration rate (RR was analyzed,RR value of table tennis players were significantlyhigher than wrestlers (p<0.05.Conclusion: As a result it was determined that respiratoryfunctions were higher among subjects who do exercisecompared to those who do not. That the respiratoryparameters of athletes doing exercise from differentbranches of star category are higher than those who donot shows the effect of training on respiratory system. Inaddition to this, the difference of respiratory functions betweenbranches shows that the sport branch influencesthe respiratory capacity.Key words: Respiratory functions, athletes, sport branches.

Respiratory trace feature analysis for the prediction of respiratory-gated PET quantification

Science.gov (United States)

Wang, Shouyi; Bowen, Stephen R.; Chaovalitwongse, W. Art; Sandison, George A.; Grabowski, Thomas J.; Kinahan, Paul E.

2014-02-01

The benefits of respiratory gating in quantitative PET/CT vary tremendously between individual patients. Respiratory pattern is among many patient-specific characteristics that are thought to play an important role in gating-induced imaging improvements. However, the quantitative relationship between patient-specific characteristics of respiratory pattern and improvements in quantitative accuracy from respiratory-gated PET/CT has not been well established. If such a relationship could be estimated, then patient-specific respiratory patterns could be used to prospectively select appropriate motion compensation during image acquisition on a per-patient basis. This study was undertaken to develop a novel statistical model that predicts quantitative changes in PET/CT imaging due to respiratory gating. Free-breathing static FDG-PET images without gating and respiratory-gated FDG-PET images were collected from 22 lung and liver cancer patients on a PET/CT scanner. PET imaging quality was quantified with peak standardized uptake value (SUVpeak) over lesions of interest. Relative differences in SUVpeak between static and gated PET images were calculated to indicate quantitative imaging changes due to gating. A comprehensive multidimensional extraction of the morphological and statistical characteristics of respiratory patterns was conducted, resulting in 16 features that characterize representative patterns of a single respiratory trace. The six most informative features were subsequently extracted using a stepwise feature selection approach. The multiple-regression model was trained and tested based on a leave-one-subject-out cross-validation. The predicted quantitative improvements in PET imaging achieved an accuracy higher than 90% using a criterion with a dynamic error-tolerance range for SUVpeak values. The results of this study suggest that our prediction framework could be applied to determine which patients would likely benefit from respiratory motion compensation

Respiratory trace feature analysis for the prediction of respiratory-gated PET quantification

International Nuclear Information System (INIS)

Wang, Shouyi; Chaovalitwongse, W Art; Bowen, Stephen R; Kinahan, Paul E; Sandison, George A; Grabowski, Thomas J

2014-01-01

The benefits of respiratory gating in quantitative PET/CT vary tremendously between individual patients. Respiratory pattern is among many patient-specific characteristics that are thought to play an important role in gating-induced imaging improvements. However, the quantitative relationship between patient-specific characteristics of respiratory pattern and improvements in quantitative accuracy from respiratory-gated PET/CT has not been well established. If such a relationship could be estimated, then patient-specific respiratory patterns could be used to prospectively select appropriate motion compensation during image acquisition on a per-patient basis. This study was undertaken to develop a novel statistical model that predicts quantitative changes in PET/CT imaging due to respiratory gating. Free-breathing static FDG-PET images without gating and respiratory-gated FDG-PET images were collected from 22 lung and liver cancer patients on a PET/CT scanner. PET imaging quality was quantified with peak standardized uptake value (SUV peak ) over lesions of interest. Relative differences in SUV peak between static and gated PET images were calculated to indicate quantitative imaging changes due to gating. A comprehensive multidimensional extraction of the morphological and statistical characteristics of respiratory patterns was conducted, resulting in 16 features that characterize representative patterns of a single respiratory trace. The six most informative features were subsequently extracted using a stepwise feature selection approach. The multiple-regression model was trained and tested based on a leave-one-subject-out cross-validation. The predicted quantitative improvements in PET imaging achieved an accuracy higher than 90% using a criterion with a dynamic error-tolerance range for SUV peak values. The results of this study suggest that our prediction framework could be applied to determine which patients would likely benefit from respiratory motion

X-ray upper airway changes in individuals suffering from obstructive respiratory disorders during sleep

International Nuclear Information System (INIS)

Shakhov, A.A.; Rabukhina, N.A.; Nerobeev, A.I.; Vasil'ev, A.Yu.

2000-01-01

Obstructive respiratory disorders during sleep present an important medical and social problem. Serious dysfunctions of cardiovascular, nervous, endocrine and other vital systems of the body reduce longevity and life quality. On the other hand, load nocturnal snore and abnormal during sleepiness cause great damage to family life, reduce working capacity and induce accidents. X-ray visualization of the upper airways is essential in diagnosing obstructive upper airway states and selecting patients for surgical treatment. The paper presents the author's own experience in using various X-ray diagnostic methods in patients with chronic snore and obstructive sleep apnoea-hypopnoea syndrome [ru

Joubert syndrome presenting as unilateral dysplastic kidney, hypotonia, and respiratory problem

Directory of Open Access Journals (Sweden)

Majid Malaki

2012-01-01

Full Text Available An 8-month-old girl with a history of asphyxia and respiratory distress immediately after birth was hospitalized at her fourth month of age with the diagnosis of kidney infection and it was revealed that she had a unilateral multicystic dysplastic kidney. In recent admission, she presented to emergency room with fever, hyperpnea, and apnea. In appearance, she was a hypotonic girl with broad forehead, hypertelorism, depressed nasal bridge and bitemporal regions, rapid vertical and horizontal nystagmus, and open mouth with salivation. In spite of normal physical growth, she had delayed developmental milestones. Blood gas O 2 saturation dropped after she received phenobarbital. Her urinary and blood tests were normal; however, her cranial magnetic resonance imaging (MRI revealed vermis agenesis and molar tooth sign. These physical and para-clinical findings suggested Joubert syndrome.

Respiratory mechanics

CERN Document Server

Wilson, Theodore A

2016-01-01

This book thoroughly covers each subfield of respiratory mechanics: pulmonary mechanics, the respiratory pump, and flow. It presents the current understanding of the field and serves as a guide to the scientific literature from the golden age of respiratory mechanics, 1960 - 2010. Specific topics covered include the contributions of surface tension and tissue forces to lung recoil, the gravitational deformation of the lung, and the interdependence forces that act on pulmonary airways and blood vessels. The geometry and kinematics of the ribs is also covered in detail, as well as the respiratory action of the external and internal intercostal muscles, the mechanics of the diaphragm, and the quantitative compartmental models of the chest wall is also described. Additionally, flow in the airways is covered thoroughly, including the wave-speed and viscous expiratory flow-limiting mechanisms; convection, diffusion and the stationary front; and the distribution of ventilation. This is an ideal book for respiratory ...

Realistic respiratory motion margins for external beam partial breast irradiation

Energy Technology Data Exchange (ETDEWEB)

Conroy, Leigh; Quirk, Sarah [Department of Medical Physics, Tom Baker Cancer Centre, Calgary, Alberta T2N 4N2 (Canada); Department of Physics and Astronomy, University of Calgary, Calgary, Alberta T2N 1N4 (Canada); Smith, Wendy L., E-mail: wendy.smith@albertahealthservices.ca [Department of Medical Physics, Tom Baker Cancer Centre, Calgary, Alberta T2N 4N2 (Canada); Department of Physics and Astronomy, University of Calgary, Calgary, Alberta T2N 1N4 (Canada); Department of Oncology, University of Calgary, Calgary, Alberta T2N 1N4 (Canada)

2015-09-15

Purpose: Respiratory margins for partial breast irradiation (PBI) have been largely based on geometric observations, which may overestimate the margin required for dosimetric coverage. In this study, dosimetric population-based respiratory margins and margin formulas for external beam partial breast irradiation are determined. Methods: Volunteer respiratory data and anterior–posterior (AP) dose profiles from clinical treatment plans of 28 3D conformal radiotherapy (3DCRT) PBI patient plans were used to determine population-based respiratory margins. The peak-to-peak amplitudes (A) of realistic respiratory motion data from healthy volunteers were scaled from A = 1 to 10 mm to create respiratory motion probability density functions. Dose profiles were convolved with the respiratory probability density functions to produce blurred dose profiles accounting for respiratory motion. The required margins were found by measuring the distance between the simulated treatment and original dose profiles at the 95% isodose level. Results: The symmetric dosimetric respiratory margins to cover 90%, 95%, and 100% of the simulated treatment population were 1.5, 2, and 4 mm, respectively. With patient set up at end exhale, the required margins were larger in the anterior direction than the posterior. For respiratory amplitudes less than 5 mm, the population-based margins can be expressed as a fraction of the extent of respiratory motion. The derived formulas in the anterior/posterior directions for 90%, 95%, and 100% simulated population coverage were 0.45A/0.25A, 0.50A/0.30A, and 0.70A/0.40A. The differences in formulas for different population coverage criteria demonstrate that respiratory trace shape and baseline drift characteristics affect individual respiratory margins even for the same average peak-to-peak amplitude. Conclusions: A methodology for determining population-based respiratory margins using real respiratory motion patterns and dose profiles in the AP direction was

Realistic respiratory motion margins for external beam partial breast irradiation

International Nuclear Information System (INIS)

Conroy, Leigh; Quirk, Sarah; Smith, Wendy L.

2015-01-01

Purpose: Respiratory margins for partial breast irradiation (PBI) have been largely based on geometric observations, which may overestimate the margin required for dosimetric coverage. In this study, dosimetric population-based respiratory margins and margin formulas for external beam partial breast irradiation are determined. Methods: Volunteer respiratory data and anterior–posterior (AP) dose profiles from clinical treatment plans of 28 3D conformal radiotherapy (3DCRT) PBI patient plans were used to determine population-based respiratory margins. The peak-to-peak amplitudes (A) of realistic respiratory motion data from healthy volunteers were scaled from A = 1 to 10 mm to create respiratory motion probability density functions. Dose profiles were convolved with the respiratory probability density functions to produce blurred dose profiles accounting for respiratory motion. The required margins were found by measuring the distance between the simulated treatment and original dose profiles at the 95% isodose level. Results: The symmetric dosimetric respiratory margins to cover 90%, 95%, and 100% of the simulated treatment population were 1.5, 2, and 4 mm, respectively. With patient set up at end exhale, the required margins were larger in the anterior direction than the posterior. For respiratory amplitudes less than 5 mm, the population-based margins can be expressed as a fraction of the extent of respiratory motion. The derived formulas in the anterior/posterior directions for 90%, 95%, and 100% simulated population coverage were 0.45A/0.25A, 0.50A/0.30A, and 0.70A/0.40A. The differences in formulas for different population coverage criteria demonstrate that respiratory trace shape and baseline drift characteristics affect individual respiratory margins even for the same average peak-to-peak amplitude. Conclusions: A methodology for determining population-based respiratory margins using real respiratory motion patterns and dose profiles in the AP direction was

Correlation between asthma and climate in the European Community Respiratory Health Survey.

Science.gov (United States)

Verlato, Giuseppe; Calabrese, Rolando; De Marco, Roberto

2002-01-01

The European Community Respiratory Health Survey, performed during 1991-1993, found a remarkable geographical variability in the prevalence of asthma and asthma-like symptoms in individuals aged 20-44 yr. The highest values occurred in the English-speaking centers. In the present investigation, the ecological relationship between climate and symptom prevalence was evaluated in the 48 centers of the European Community Respiratory Health Survey. Meteorological variables were derived from the Global Historical Climatology Network and were averaged over an 11-yr period (i.e., 1980-1990). Respiratory symptom prevalence was directly related to temperature in the coldest month and was related inversely to the temperature in the hottest month. Warm winters and cool summers are features of oceanic climate found in most English-speaking centers of the European Community Respiratory Health Survey (i.e., England, New Zealand, and Oregon). In conclusion, climate can account for significant geographic variability in respiratory symptom prevalence.

Respiratory manifestations of panic disorder: causes, consequences and therapeutic implications.

Science.gov (United States)

Sardinha, Aline; Freire, Rafael Christophe da Rocha; Zin, Walter Araújo; Nardi, Antonio Egidio

2009-07-01

Multiple respiratory abnormalities can be found in anxiety disorders, especially in panic disorder (PD). Individuals with PD experience unexpected panic attacks, characterized by anxiety and fear, resulting in a number of autonomic and respiratory symptoms. Respiratory stimulation is a common event during panic attacks. The respiratory abnormality most often reported in PD patients is increased CO2 sensitivity, which has given rise to the hypothesis of fundamental abnormalities in the physiological mechanisms that control breathing in PD. There is evidence that PD patients with dominant respiratory symptoms are more sensitive to respiratory tests than are those who do not manifest such symptoms, and that the former group constitutes a distinct subtype. Patients with PD tend to hyperventilate and to panic in response to respiratory stimulants such as CO2, triggering the activation of a hypersensitive fear network. Although respiratory physiology seems to remain normal in these subjects, recent evidence supports the idea that they present subclinical abnormalities in respiration and in other functions related to body homeostasis. The fear network, composed of the hippocampus, the medial prefrontal cortex, the amygdala and its brain stem projections, might be oversensitive in PD patients. This theory might explain why medication and cognitive-behavioral therapy are both clearly effective. Our aim was to review the relationship between respiration and PD, addressing the respiratory subtype of PD and the hyperventilation syndrome, with a focus on respiratory challenge tests, as well as on the current mechanistic concepts and the pharmacological implications of this relationship.

Neurological Respiratory Failure

Directory of Open Access Journals (Sweden)

Mohan Rudrappa

2018-01-01

Full Text Available West Nile virus infection in humans is mostly asymptomatic. Less than 1% of neuro-invasive cases show a fatality rate of around 10%. Acute flaccid paralysis of respiratory muscles leading to respiratory failure is the most common cause of death. Although the peripheral nervous system can be involved, isolated phrenic nerve palsy leading to respiratory failure is rare and described in only two cases in the English literature. We present another case of neurological respiratory failure due to West Nile virus-induced phrenic nerve palsy. Our case reiterates the rare, but lethal, consequences of West Nile virus infection, and the increase of its awareness among physicians.

Evaluation of exercise-respiratory system modifications and preliminary respiratory-circulatory system integration scheme

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Gallagher, R. R.

1974-01-01

The respiratory control system, functioning as an independent system, is presented with modifications of the exercise subroutine. These modifications illustrate an improved control of ventilation rates and arterial and compartmental gas tensions. A very elementary approach to describing the interactions of the respiratory and circulatory system is presented.

Respiratory syncytial virus in adults with severe acute respiratory illness in a high HIV prevalence setting.

Science.gov (United States)

Moyes, Jocelyn; Walaza, Sibongile; Pretorius, Marthi; Groome, Michelle; von Gottberg, Anne; Wolter, Nicole; Haffejee, Sumayya; Variava, Ebrahim; Cohen, Adam L; Tempia, Stefano; Kahn, Kathleen; Dawood, Halima; Venter, Marietjie; Cohen, Cheryl; Madhi, Shabir A

2017-10-01

There are limited data on the epidemiology of respiratory syncytial virus (RSV) illness in HIV-infected adults or the elderly in Africa. We studied the epidemiology of RSV-associated severe acute respiratory illness (SARI) hospitalizations in adults in South Africa from 2009 through 2013. Individuals admitted to sentinel surveillance hospitals were investigated by respiratory tract swabs for RSV, using a multiplex real-time polymerase chain reaction assay. The incidence of RSV-associated SARI was calculated for the one site with population denominators. Of 7796 participants investigated, 329 (4%) tested positive for RSV. On multivariable analysis, HIV-infected individuals with RSV-associated SARI had greater odds of being in the age groups 18-44 and 45-64 years (odd ratios (OR) 26.3; 95% confidence interval (CI) 6.2-112.1 and OR 11.4; 95% CI 2.6-50.0) compared with those ≥65 years and being female (OR 2.7; 95% CI 1.4-5.4). The relative risk of hospitalization with RSV-associated SARI was 12-18 times higher in HIV infected individual compared to that of HIV-uninfected. The incidence of RSV-associated SARI was higher in HIV-infected individuals and those aged 65 years and older. Further studies are warranted to describe the disease association of RSV detected in adults with SARI. Copyright © 2017 The British Infection Association. All rights reserved.

Active Video Games as a Training Tool for Individuals With Chronic Respiratory Diseases: A SYSTEMATIC REVIEW.

Science.gov (United States)

Butler, Stacey J; Lee, Annemarie L; Goldstein, Roger S; Brooks, Dina

2018-02-26

Exercise is an effective treatment for reducing symptom severity and improving quality of life for patients with chronic respiratory diseases. Active video games offer a new and enjoyable way to exercise and have gained popularity in a rehabilitation setting. However, it is unclear whether they achieve comparable physiological and clinical effects as traditional exercise training. A systematic literature search was performed to identify studies that included an active video game component as a form of exercise training and a comparator group in chronic respiratory disease. Two assessors independently reviewed study quality using the Cochrane risk of bias tool and extracted data for exercise capacity, quality of life, and preference of exercise model. Six studies were included in this review. Because of the heterogeneity of the populations, study designs, length of intervention, and outcome measures, meta-analysis could not be performed. Active video game training resulted in comparable training maximal heart rate and dyspnea levels to those achieved when exercising using a treadmill or cycle (n = 5). There was insufficient evidence (n = 3) to determine whether active video game training improved exercise capacity as measured by 6-min walk test or treadmill endurance walking. Although the quality of evidence was low, in a small number of studies active video games induced peak heart rates and dyspnea levels comparable with traditional exercise training. Larger and longer-term randomized controlled trials are needed to establish the impact of video game training for individuals with chronic respiratory diseases.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

Present-day potentialities of endoscopic diagnostics and treatment of early cancer in respiratory and digestive tracts

Science.gov (United States)

Sokolov, Victor V.; Zharkova, Natalia N.; Filonenko, E. V.; Telegina, L. V.; Karpova, E. S.

1999-12-01

The paper presents the latest potentialities of the endoscopic fluorescent diagnostics as well as endoscopic electric-, laser surgery and photodynamic therapy (PDT) of the early cancer in the respiratory and digestive tracts. We present in detail indication and factors determining the application of the endoscopic resection of the tumor. The advantages of the combination application of PDT, electro-, Nd:YAG laser surgery and brachitherapy are stressed. The near and remote results of endoscopic treatment of the early cancer in larynx (37), lung (109), esophagus (39) and stomach (58) are shown.

Short-term respiratory effects of e-cigarettes in healthy individuals and smokers with asthma.

Science.gov (United States)

Lappas, Andreas S; Tzortzi, Anna S; Konstantinidi, Efstathia M; Teloniatis, Stephanie I; Tzavara, Chara K; Gennimata, Sofia A; Koulouris, Nikolaos G; Behrakis, Panagiotis K

2018-03-01

This study investigated the duration of immediate respiratory effects of e-cigarette smoking (ECS) and tested the hypothesis that ECS has more prominent effects in asthmatics compared with healthy smokers (HS). Fifty-four smokers, 27 healthy (HS group) and 27 with intermittent asthma (mild asthma (MA) group) underwent a control session (no liquid, no resistor coil inside e-cigarette cartridge) and an experimental session of ECS using standardized puffing settings. Impulse oscillometry impedance (Z), resistance (R), reactance (X) and fractional exhaled nitric oxide (FeNO) were measured before and 0, 15 and 30 min after control and experimental sessions. Control session revealed no significant changes. In the experimental session, immediately post-ECS, both groups exhibited a significant increase in respiratory system total impedance at 5 Hz (Z5) (P < 0.001), respiratory system resistance at 5 Hz (R5) (P < 0.001), respiratory system resistance at 10 Hz (R10) (P < 0.001), respiratory system resistance at 20 Hz (R20) (P < 0.05), resonant frequency (P < 0.001) and reactance area (P < 0.05). MA exhibited higher baseline values and a more prominent effect immediately after ECS compared with HS for Z5 (P = 0.022), R5 (P = 0.010) and R10 (P = 0.013). FeNO decreased significantly in both groups (P < 0.001); HS returned to baseline values in ≤15 min while the MA maintained significantly lower values for an additional 15 min (P < 0.05) and returned to baseline values at 30 min post-ECS. A single session of ECS had respiratory mechanical and inflammatory effects, which were more prominent in smokers with asthma. © 2017 Asian Pacific Society of Respirology.

Antisynthetase syndrome (ASS) presenting as acute respiratory distress syndrome (ARDS) in a patient without myositis features.

Science.gov (United States)

Kanchustambham, Venkat Kiran; Saladi, Swetha; Mahmoudassaf, Sarah; Patolia, Setu

2016-12-09

A woman aged 61 years presented to the emergency room with a 1-week history of dyspnoea on exertion and dry cough. X-ray of the chest showed diffuse interstitial opacities and was started on antibiotics and furosemide, and despite these measures, patient's respiratory status worsened, prompting endotracheal intubation. CT of the chest showed diffuse bilateral ground glass opacities and underwent bronchoscope with trans-bronchial biopsy that showed chronic bronchitis. Pt was empirically started on intravenous steroids due to concerns for interstitial lung disease (ILD). Autoimmune work up was sent and underwent video-assisted thoracoscopic surgery-guided biopsy of the lung that showed non-specific interstitial pattern with fibrosis. The patient was diagnosed as having antisynthetase syndrome with pulmonary involvement (ILD) as the cause of her acute respiratory failure. Azathioprine was started as steroid-sparing agent and was weaned off the ventilator to a tracheostomy collar and discharged to long-term rehabilitation centre. 2016 BMJ Publishing Group Ltd.

Lung-Protective Ventilation With Low Tidal Volumes and the Occurrence of Pulmonary Complications in Patients Without Acute Respiratory Distress Syndrome: A Systematic Review and Individual Patient Data Analysis.

Science.gov (United States)

Neto, Ary Serpa; Simonis, Fabienne D; Barbas, Carmen S V; Biehl, Michelle; Determann, Rogier M; Elmer, Jonathan; Friedman, Gilberto; Gajic, Ognjen; Goldstein, Joshua N; Linko, Rita; Pinheiro de Oliveira, Roselaine; Sundar, Sugantha; Talmor, Daniel; Wolthuis, Esther K; Gama de Abreu, Marcelo; Pelosi, Paolo; Schultz, Marcus J

2015-10-01

Protective mechanical ventilation with low tidal volumes is standard of care for patients with acute respiratory distress syndrome. The aim of this individual patient data analysis was to determine the association between tidal volume and the occurrence of pulmonary complications in ICU patients without acute respiratory distress syndrome and the association between occurrence of pulmonary complications and outcome in these patients. Individual patient data analysis. ICU patients not fulfilling the consensus criteria for acute respiratory distress syndrome at the onset of ventilation. Mechanical ventilation with low tidal volume. The primary endpoint was development of a composite of acute respiratory distress syndrome and pneumonia during hospital stay. Based on the tertiles of tidal volume size in the first 2 days of ventilation, patients were assigned to a "low tidal volume group" (tidal volumes ≤ 7 mL/kg predicted body weight), an "intermediate tidal volume group" (> 7 and volume group" (≥ 10 mL/kg predicted body weight). Seven investigations (2,184 patients) were included. Acute respiratory distress syndrome or pneumonia occurred in 23% of patients in the low tidal volume group, in 28% of patients in the intermediate tidal volume group, and in 31% of the patients in the high tidal volume group (adjusted odds ratio [low vs high tidal volume group], 0.72; 95% CI, 0.52-0.98; p = 0.042). Occurrence of pulmonary complications was associated with a lower number of ICU-free and hospital-free days and alive at day 28 (10.0 ± 10.9 vs 13.8 ± 11.6 d; p volumes is associated with a lower risk of development of pulmonary complications in patients without acute respiratory distress syndrome.

Indoor air pollution and respiratory health in the elderly.

Science.gov (United States)

Bentayeb, Malek; Simoni, Marzia; Norback, Dan; Baldacci, Sandra; Maio, Sara; Viegi, Giovanni; Annesi-Maesano, Isabella

2013-01-01

Data on respiratory effects of indoor air pollution in elderly are scanty. The purpose of this review is to summarize current knowledge on adverse respiratory effects of indoor air pollution in individuals aged over 65 years, by presenting existing epidemiological evidence. Using MEDLINE database through PubMed, we identified relevant publications published between 1991 and 2011 in English on respiratory health effects of indoor air pollution in elderly (>65 years). A total of 61 studies were found and after application of the inclusion criteria: (i) epidemiologic studies published in English in peer-reviewed journals between January 1991 and December 2011, (ii) study population with age over or equal 65 years, and (iii) outcome of respiratory symptoms and disease with the exclusion of lung cancer, 33 relevant publications were selected. Most of them showed significant relationships between exposure to major indoor air pollutants and various short-term and long-term respiratory health outcomes such as wheezing, breathlessness, cough, phlegm, asthma, COPD, lung cancer and more rarely lung function decline. The most consistent relationship is found between chronic obstructive pulmonary disease (COPD) and environmental tobacco smoke (ETS). Further studies in the elderly population are needed in order to define causal relationships between exposures to indoor air pollution and underlying mechanisms in this sub-population.

Frequency of viral etiology in symptomatic adult upper respiratory tract infections

Directory of Open Access Journals (Sweden)

Raquel Cirlene da Silva

2015-01-01

Conclusion: Results presented in this report suggest that respiratory viral infections are largely under diagnosed in immunocompetent adults. Although the majority of young adult infections are not life-threatening they may impose a significant burden, especially in developing countries since these individuals represent a large fraction of the working force.

Investigations of respiratory control systems simulation

Science.gov (United States)

Gallagher, R. R.

1973-01-01

The Grodins' respiratory control model was investigated and it was determined that the following modifications were necessary before the model would be adaptable for current research efforts: (1) the controller equation must be modified to allow for integration of the respiratory system model with other physiological systems; (2) the system must be more closely correlated to the salient physiological functionings; (3) the respiratory frequency and the heart rate should be expanded to illustrate other physiological relationships and dependencies; and (4) the model should be adapted to particular individuals through a better defined set of initial parameter values in addition to relating these parameter values to the desired environmental conditions. Several of Milhorn's respiratory control models were also investigated in hopes of using some of their features as modifications for Grodins' model.

Does high-resolution CT has diagnostic value in patients presenting with respiratory symptoms after hematopoietic stem cell transplantation?

International Nuclear Information System (INIS)

Wijers, Sofieke C.; Boelens, Jaap Jan; Raphael, Martine F.; Beek, Frederik J.; Jong, Pim A. de

2011-01-01

Background: Hematopoietic stem cell transplantation (SCT) can be complicated by a variety of live-threatening infectious and non-infectious pulmonary complications. The management of these complications is critically dependent on the most probable diagnosis, which is in part based on imaging work-up. Methods: Systematic review of the literature related to the diagnostic value of high-resolution computed tomography (HRCT) in patients who underwent SCT and developed respiratory symptoms. Results: Literature review did not reveal systematic cohort studies that included patients with respiratory symptoms post-SCT who underwent HRCT and had a well-defined outcome. Most studies selected participants based on their final diagnosis instead of the indication for diagnostic testing in practice. Nevertheless, several papers clearly indicated a potential role for HRCT when complications after SCT occur. A variety of articles described the role of certain HRCT findings in the diagnosis of specific infectious complications, but less data were available for non-infectious complications. Conclusion: We believe more diagnostic studies are needed to determine the value of HRCT for a specific diagnosis in SCT-recipients who present with respiratory symptoms at the transplant clinic. Currently, radiologists should be cautious since HRCT interpretation in these patients is not unambiguous.

European Respiratory Society statement

DEFF Research Database (Denmark)

Miravitlles, Marc; Dirksen, Asger; Ferrarotti, Ilaria

2017-01-01

lung disease. A large proportion of individuals affected remain undiagnosed and therefore without access to appropriate care and treatment.The most recent international statement on AATD was published by the American Thoracic Society and the European Respiratory Society in 2003. Since then there has...

The Respiratory Presentation of Severe Combined Immunodeficiency in Two Mennonite Children at a Tertiary Centre Highlighting the Importance of Recognizing This Pediatric Emergency

OpenAIRE

Simon Lam; Fotini D Kavadas; Seemab Haider; Mary E Noseworthy

2014-01-01

Severe combined immunodeficiency (SCID) is considered to be a pediatric emergency, with respiratory distress being the most common presenting symptom. The authors present two cases of SCID in children

Construction, Presentation and Consumption of Individualism in Social Media

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Gulsum Calisir

2014-12-01

Full Text Available The concept ıf individualism involves the whole properties of being esteemed and confirmed of the individual in society. The situation of being esteemed is an extension of individuality. Together with social media, individuals can build new individualities right along with the present. Social media offers individuals a new “individuality area”. As a socialization medium, social media also lays the grounwork for a consumption of individualism during daily use. Different than consumption in real life, it is allowed for individual’s consumption of individualism by texts, visuality, varied connections and comments in social media. At the same time, individual also exhausts his or her own individualism during construction process of his or her own individualism. Consumption of individualism in daily life, seems to find its imaginary equivalent in social media. Individual realizes a consumption by sharing in social media what he or she eats, places he or she visits or shops in real life. In this way,individual both is able to reach more wide areas and to continue to be on the agenda. Social media offers individuals this chance. Individual can be on the agenda as he or she consumes and shares to the extent. As soon as the individual achieves this, he or she can gain admiration and comment; but at the moment he or she becomes silent, individual encounters the risk of falling down the agenda. So, individual trends to expend more in real life tos tay active in virtual world. The agenda in the real world is not enough anymore. Individual is wishing to deploy on a much more broad area in virtual world. In this respect, the work takes individual’s dilemma of construction and consumption of individualism which he or she builds on social media, as its case.

Human metapneumovirus and respiratory syncytial virus in hospitalized danish children with acute respiratory tract infection

DEFF Research Database (Denmark)

von Linstow, Marie-Louise; Henrik Larsen, Hans; Koch, Anders

2004-01-01

The newly discovered human metapneumovirus (hMPV) has been shown to be associated with respiratory illness. We determined the frequencies and clinical features of hMPV and respiratory syncytial virus (RSV) infections in 374 Danish children with 383 episodes of acute respiratory tract infection...... children 1-6 months of age. Asthmatic bronchitis was diagnosed in 66.7% of hMPV and 10.6% of RSV-infected children (p respiratory support. hMPV is present in young...

Acute respiratory infections at children

OpenAIRE

Delyagin, V.

2009-01-01

The common signs of virus respiratory diseases, role of pathological inclination to infections, value of immunodeficiency are presented at lecture. Features of most often meeting respiratory virus infections are given.

Respiratory distress and chest pain: a perforated peptic ulcer with an unusual presentation.

Science.gov (United States)

Bruner, David I; Gustafson, Corey

2011-06-22

Dyspnea and chest pain are common presenting complaints to the ED, and coupled together can present a challenging diagnostic dilemma in patients in extremis. A thoughtful evaluation is required, giving due diligence to the immediate life threats as well as multiple etiologies which can cause serious morbidity. A perforated peptic ulcer is one such possibility and requires rapid diagnosis and prompt intervention to avoid the associated high risk of morbidity and mortality. We present a case report of a 54 year old man with respiratory distress and chest pain as the initial Emergency Department presentation of a perforated duodenal ulcer. We discuss an unusual presentation of a perforated duodenal ulcer that was recognized in the emergency department and treated promptly. The patient was surgically treated immediately, had a prolonged and complicated post-operative course, but is ultimately doing well. We also provide a brief literature review of the risk factors, imaging choices, and management decision required to treat a perforated ulcer. Perforated ulcers can have highly varied presentations and are occasionally difficult to diagnose in a complicated patient. Knowledge of the risk factors and a thorough history and physical can point to the diagnosis, but timely and appropriate imaging is often required because delays in diagnosis and treatment lead to poor outcomes. Early administration of antibiotics and immediate surgical repair are necessary to limit morbidity and mortality.

Evaluation of the Usefulness of the Respiratory Guidance System in the Respiratory Gating Radiation Therapy

Energy Technology Data Exchange (ETDEWEB)

Lee, Yeong Cheol; Kim, Sun Myung; Do, Gyeong Min; Park, Geun Yong; Kim, Gun Oh; Kim, Young Bum [Dept. of Radiation Oncology, Guro Hospital, Korea Univeristy, Seoul (Korea, Republic of)

2012-09-15

The respiration is one of the most important factors in respiratory gating radiation therapy (RGRT). We have developed an unique respiratory guidance system using an audio-visual system in order to support and stabilize individual patient's respiration and evaluated the usefulness of this system. Seven patients received the RGRT at our clinic from June 2011 to April 2012. After breathing exercise standard deviations by the superficial contents of respiratory cycles and functions, and analyzed them to examine changes in their breathing before and with the audio-visual system, we measured their spontaneous respiration and their respiration with the audio-visual system respectively. With the measured data, we yielded after the therapy. The PTP (peak to peak) of the standard deviations of the free breathing, the audio guidance system, and the respiratory guidance system were 0.343, 0.148, and 0.078 respectively. The respiratory cycles were 0.645, 0.345, and 0.171 respectively and the superficial contents of the respiratory functions were 2.591, 1.008, and 0.877 respectively. The average values of the differences in the standard deviations among the whole patients at the CT room and therapy room were 0.425 for the PTP, 1.566 for the respiratory cycles, and 3.671 for the respiratory superficial contents. As for the standard deviations before and after the application of the PTP respiratory guidance system, that of the PTP was 0.265, that of the respiratory cycles was 0.474, and that of the respiratory superficial contents. The results of t-test of the values before and after free breathing and the audio-visual guidance system showed that the P-value of the PTP was 0.035, that of the cycles 0.009, and that of the respiratory superficial contents 0.010. The respiratory control could be one of the most important factors in the RGRT which determines the success or failure of a treatment. We were able to get more stable breathing with the audio-visual respiratory

Evaluation of the Usefulness of the Respiratory Guidance System in the Respiratory Gating Radiation Therapy

International Nuclear Information System (INIS)

Lee, Yeong Cheol; Kim, Sun Myung; Do, Gyeong Min; Park, Geun Yong; Kim, Gun Oh; Kim, Young Bum

2012-01-01

The respiration is one of the most important factors in respiratory gating radiation therapy (RGRT). We have developed an unique respiratory guidance system using an audio-visual system in order to support and stabilize individual patient's respiration and evaluated the usefulness of this system. Seven patients received the RGRT at our clinic from June 2011 to April 2012. After breathing exercise standard deviations by the superficial contents of respiratory cycles and functions, and analyzed them to examine changes in their breathing before and with the audio-visual system, we measured their spontaneous respiration and their respiration with the audio-visual system respectively. With the measured data, we yielded after the therapy. The PTP (peak to peak) of the standard deviations of the free breathing, the audio guidance system, and the respiratory guidance system were 0.343, 0.148, and 0.078 respectively. The respiratory cycles were 0.645, 0.345, and 0.171 respectively and the superficial contents of the respiratory functions were 2.591, 1.008, and 0.877 respectively. The average values of the differences in the standard deviations among the whole patients at the CT room and therapy room were 0.425 for the PTP, 1.566 for the respiratory cycles, and 3.671 for the respiratory superficial contents. As for the standard deviations before and after the application of the PTP respiratory guidance system, that of the PTP was 0.265, that of the respiratory cycles was 0.474, and that of the respiratory superficial contents. The results of t-test of the values before and after free breathing and the audio-visual guidance system showed that the P-value of the PTP was 0.035, that of the cycles 0.009, and that of the respiratory superficial contents 0.010. The respiratory control could be one of the most important factors in the RGRT which determines the success or failure of a treatment. We were able to get more stable breathing with the audio-visual respiratory guidance

Hippotherapy and respiratory muscle strength in children and adolescents with Down syndrome

Directory of Open Access Journals (Sweden)

Valéria Sovat de Freitas Costa

Full Text Available Introduction Individuals with Down syndrome may have decreased respiratory muscle strength due to hypotonia, a common characteristic in this population. Objective To analyze the effects of a hippotherapy program on respiratory muscle strength in individuals with Down syndrome. Materials and methods The study included 41 subjects, 20 of which were in the hippotherapy practicing group (PG and 21 of which were in the non-practicing group (NPG. Study subjects were of both sexes, aged 7-13 years, and all diagnosed with Down syndrome. A manovacuometer was used to measure respiratory muscle strength, following the protocol proposed by Black and Hyatt (23. Statistical analysis was performed by means of descriptive distribution. After verifying normality and homoscedasticity of the variables, the Mann-Whitney test was used to determine differences between the means of the two groups (PG and NPG, and the Spearman’s rank correlation coefficient test was used to view possible relationships with age and time practicing hippotherapy. Significance was set at p < 0.05. Results and discussion Individuals who practiced hippotherapy showed improvements in both inspiratory and expiratory respiratory muscle strength, although no significant difference was demonstrated. Conclusion This study demonstrates that hippotherapy benefits respiratory muscle strength in individuals with Down syndrome, and that the youngest subjects had the best results.

Evaluation of the current landscape of respiratory nurse specialists in the UK: planning for the future needs of patients.

Science.gov (United States)

Yorke, Janelle; Prigmore, Sam; Hodson, Matt; Stonham, Carol; Long, Hannah; Bellhouse, Sarah; Fletcher, Monica; Edwards, Sheila

2017-01-01

The National Health Service currently faces significant challenges and must optimise effective workforce planning and management. There are increasing concerns regarding poor workforce planning for respiratory medicine; a greater understanding of the role of respiratory nurse specialists will inform better workforce planning and management. This was a survey study. Two surveys were administered: an organisational-level survey and an individual respiratory nurse survey. There were 148 and 457 respondents to the organisational and individual nurse survey, respectively. Four main themes are presented: (1) breadth of service provided; (2) patient care; (3) work environment; and (4) succession planning. The majority of work conducted by respiratory nurse specialists relates to patient care outside the secondary care setting including supporting self-management in the home, supporting patients on home oxygen, providing hospital-at-home services and facilitating early discharge from acute care environments. Yet, most respiratory nursing teams are employed by secondary care trusts and located within acute environments. There was evidence of multidisciplinary working, although integrated care was not prominent in the free-text responses. High workload was reported with one-quarter of nursing teams short-staffed. Respiratory nurses reported working unpaid extra hours and a lack of administrative support that often took them away from providing direct patient care. Nearly half of the present sample either plan to retire or are eligible for retirement within 10 years. This survey report provides a current snapshot of the respiratory nurse specialist workforce in the UK. This workforce is an ageing population; the results from this survey can be used to inform succession planning and to ensure a viable respiratory nurse specialist workforce in future.

[Undernutrition in chronic respiratory diseases].

Science.gov (United States)

Zielonka, Tadeusz M; Hadzik-Błaszczyk, Małgorzata

2015-01-01

Respiratory diseases such as asthma, COPD, lung cancer, infections, including also tuberculosis constitute the most frequent diseases in the word. Undernutrition frequently accompanies these diseases. Early diagnosis of malnutrition and implementation of appropriate treatment is very important. A nutritional interview and anthropometric examinations, such as body mass index, fat free mass and fat mass are used to diagnose it. Nutritional therapy affects the course and prognosis of these diseases. Diet should be individually adjusted to the calculated caloric intake that increases during exacerbation of disease, because of increased respiratory effort. Too large supply of energy can cause increase metabolism, higher oxygen consumption and PaCO2 increase each dangerous for patients with respiratory insufficiency. Main source of carbohydrates for these patients should be products with low glycemic index and with high dietary fiber contents. Large meals should be avoided since they cause rapid satiety, abdominal discomfort and have negative impact on the work of the respiratory muscles, especially of the diaphragm. Dietary supplements can be used in case of ineffectiveness of diet or for the patients with severe undernutrition.

Respiratory care management information systems.

Science.gov (United States)

Ford, Richard M

2004-04-01

Hospital-wide computerized information systems evolved from the need to capture patient information and perform billing and other financial functions. These systems, however, have fallen short of meeting the needs of respiratory care departments regarding work load assessment, productivity management, and the level of outcome reporting required to support programs such as patient-driven protocols. The respiratory care management information systems (RCMIS) of today offer many advantages over paper-based systems and hospital-wide computer systems. RCMIS are designed to facilitate functions specific to respiratory care, including assessing work demand, assigning and tracking resources, charting, billing, and reporting results. RCMIS incorporate mobile, point-of-care charting and are highly configurable to meet the specific needs of individual respiratory care departments. Important and substantial benefits can be realized with an RCMIS and mobile, wireless charting devices. The initial and ongoing costs of an RCMIS are justified by increased charge capture and reduced costs, by way of improved productivity and efficiency. It is not unusual to recover the total cost of an RCMIS within the first year of its operation. In addition, such systems can facilitate and monitor patient-care protocols and help to efficiently manage the vast amounts of information encountered during the practitioner's workday. Respiratory care departments that invest in RCMIS have an advantage in the provision of quality care and in reducing expenses. A centralized respiratory therapy department with an RCMIS is the most efficient and cost-effective way to monitor work demand and manage the hospital-wide allocation of respiratory care services.

Correction of glutathione deficiency in the lower respiratory tract of HIV seropositive individuals by glutathione aerosol treatment.

Science.gov (United States)

Holroyd, K J; Buhl, R; Borok, Z; Roum, J H; Bokser, A D; Grimes, G J; Czerski, D; Cantin, A M; Crystal, R G

1993-10-01

Concentrations of glutathione, a ubiquitous tripeptide with immune enhancing and antioxidant properties, are decreased in the blood and lung epithelial lining fluid of human immunodeficiency virus (HIV) seropositive individuals. Since the lung is the most common site of infection in those who progress to AIDS it is rational to consider whether it is possible to safely augment glutathione levels in the epithelial lining fluid of HIV seropositive individuals, thus potentially improving local host defence. Purified reduced glutathione was delivered by aerosol to HIV seropositive individuals (n = 14) and the glutathione levels in lung epithelial lining fluid were compared before and at one, two, and three hours after aerosol administration. Before treatment total glutathione concentrations in the epithelial lining fluid were approximately 60% of controls. After three days of twice daily doses each of 600 mg reduced glutathione, total glutathione levels in the epithelial lining fluid increased and remained in the normal range for at least three hours after treatment. Strikingly, even though > 95% of the glutathione in the aerosol was in its reduced form, the percentage of oxidised glutathione in epithelial lining fluid increased from 5% before treatment to about 40% three hours after treatment, probably reflecting the use of glutathione as an antioxidant in vivo. No adverse effects were observed. It is feasible and safe to use aerosolised reduced glutathione to augment the deficient glutathione levels of the lower respiratory tract of HIV seropositive individuals. It is rational to evaluate further the efficacy of this tripeptide in improving host defence in HIV seropositive individuals.

House Dust Mite Respiratory Allergy

DEFF Research Database (Denmark)

Calderón, Moisés A; Kleine-Tebbe, Jörg; Linneberg, Allan

2015-01-01

Although house dust mite (HDM) allergy is a major cause of respiratory allergic disease, specific diagnosis and effective treatment both present unresolved challenges. Guidelines for the treatment of allergic rhinitis and asthma are well supported in the literature, but specific evidence on the e......Although house dust mite (HDM) allergy is a major cause of respiratory allergic disease, specific diagnosis and effective treatment both present unresolved challenges. Guidelines for the treatment of allergic rhinitis and asthma are well supported in the literature, but specific evidence...... not extend beyond the end of treatment. Finally, allergen immunotherapy has a poor but improving evidence base (notably on sublingual tablets) and its benefits last after treatment ends. This review identifies needs for deeper physician knowledge on the extent and impact of HDM allergy in respiratory disease...... and therapy of HDM respiratory allergy in practice....

Design and characterization of epitope-scaffold immunogens that present the motavizumab epitope from respiratory syncytial virus.

Science.gov (United States)

McLellan, Jason S; Correia, Bruno E; Chen, Man; Yang, Yongping; Graham, Barney S; Schief, William R; Kwong, Peter D

2011-06-24

Respiratory syncytial virus (RSV) is a major cause of respiratory tract infections in infants, but an effective vaccine has not yet been developed. An ideal vaccine would elicit protective antibodies while avoiding virus-specific T-cell responses, which have been implicated in vaccine-enhanced disease with previous RSV vaccines. We propose that heterologous proteins designed to present RSV-neutralizing antibody epitopes and to elicit cognate antibodies have the potential to fulfill these vaccine requirements, as they can be fashioned to be free of viral T-cell epitopes. Here we present the design and characterization of three epitope-scaffolds that present the epitope of motavizumab, a potent neutralizing antibody that binds to a helix-loop-helix motif in the RSV fusion glycoprotein. Two of the epitope-scaffolds could be purified, and one epitope-scaffold based on a Staphylococcus aureus protein A domain bound motavizumab with kinetic and thermodynamic properties consistent with the free epitope-scaffold being stabilized in a conformation that closely resembled the motavizumab-bound state. This epitope-scaffold was well folded as assessed by circular dichroism and isothermal titration calorimetry, and its crystal structure (determined in complex with motavizumab to 1.9 Å resolution) was similar to the computationally designed model, with all hydrogen-bond interactions critical for binding to motavizumab preserved. Immunization of mice with this epitope-scaffold failed to elicit neutralizing antibodies but did elicit sera with F binding activity. The elicitation of F binding antibodies suggests that some of the design criteria for eliciting protective antibodies without virus-specific T-cell responses are being met, but additional optimization of these novel immunogens is required. Published by Elsevier Ltd.

Respiratory microbes present in the nasopharynx of children hospitalised with suspected pulmonary tuberculosis in Cape Town, South Africa

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Felix S. Dube

2016-10-01

Full Text Available Abstract Background Lower respiratory tract infection in children is increasingly thought to be polymicrobial in origin. Children with symptoms suggestive of pulmonary tuberculosis (PTB may have tuberculosis, other respiratory tract infections or co-infection with Mycobacterium tuberculosis and other pathogens. We aimed to identify the presence of potential respiratory pathogens in nasopharyngeal (NP samples from children with suspected PTB. Method NP samples collected from consecutive children presenting with suspected PTB at Red Cross Children’s Hospital (Cape Town, South Africa were tested by multiplex real-time RT-PCR. Mycobacterial liquid culture and Xpert MTB/RIF was performed on 2 induced sputa obtained from each participant. Children were categorised as definite-TB (culture or qPCR [Xpert MTB/RIF] confirmed, unlikely-TB (improvement of symptoms without TB treatment on follow-up and unconfirmed-TB (all other children. Results Amongst 214 children with a median age of 36 months (interquartile range, [IQR] 19–66 months, 34 (16 % had definite-TB, 86 (40 % had unconfirmed-TB and 94 (44 % were classified as unlikely-TB. Moraxella catarrhalis (64 %, Streptococcus pneumoniae (42 %, Haemophilus influenzae spp (29 % and Staphylococcus aureus (22 % were the most common bacteria detected in NP samples. Other bacteria detected included Mycoplasma pneumoniae (9 %, Bordetella pertussis (7 % and Chlamydophila pneumoniae (4 %. The most common viruses detected included metapneumovirus (19 %, rhinovirus (15 %, influenza virus C (9 %, adenovirus (7 %, cytomegalovirus (7 % and coronavirus O43 (5.6 %. Both bacteria and viruses were detected in 73, 55 and 56 % of the definite, unconfirmed and unlikely-TB groups, respectively. There were no significant differences in the distribution of respiratory microbes between children with and without TB. Using quadratic discriminant analysis, human metapneumovirus, C. pneumoniae, coronavirus 043

Effects of Individual Differences in Working Memory on Plan Presentational Choices.

Science.gov (United States)

Tintarev, Nava; Masthoff, Judith

2016-01-01

This paper addresses research questions that are central to the area of visualization interfaces for decision support: (RQ1) whether individual user differences in working memory should be considered when choosing how to present visualizations; (RQ2) how to present the visualization to support effective decision making and processing; and (RQ3) how to evaluate the effectiveness of presentational choices. These questions are addressed in the context of presenting plans, or sequences of actions, to users. The experiments are conducted in several domains, and the findings are relevant to applications such as semi-autonomous systems in logistics. That is, scenarios that require the attention of humans who are likely to be interrupted, and require good performance but are not time critical. Following a literature review of different types of individual differences in users that have been found to affect the effectiveness of presentational choices, we consider specifically the influence of individuals' working memory (RQ1). The review also considers metrics used to evaluate presentational choices, and types of presentational choices considered. As for presentational choices (RQ2), we consider a number of variants including interactivity, aggregation, layout, and emphasis. Finally, to evaluate the effectiveness of plan presentational choices (RQ3) we adopt a layered-evaluation approach and measure performance in a dual task paradigm, involving both task interleaving and evaluation of situational awareness. This novel methodology for evaluating visualizations is employed in a series of experiments investigating presentational choices for a plan. A key finding is that emphasizing steps (by highlighting borders) can improve effectiveness on a primary task, but only when controlling for individual variation in working memory.

Effects of Individual Differences in Working Memory on Plan Presentational Choices

Directory of Open Access Journals (Sweden)

Nava Tintarev

2016-11-01

Full Text Available This paper addresses research questions that are central to the area of visualization interfaces for decision support: RQ1 whether individual user differences in working memory should be considered when making choosing how to present visualizations; RQ2 how to present the visualization to support effective decision making and processing; and RQ3 how to evaluate the effectiveness of presentational choices. These questions are addressed in the context of presenting plans, or sequences of actions, to users. The experiments are conducted in several domains, and the findings are relevant to applications such as semi-autonomous systems in logistics. That is, scenarios that require the attention of humans who are likely to be interrupted, and require good performance but are not time critical. Following a literature review of different types of individual differences in users that have been found to affect the effectiveness of presentational choices, we consider specifically the influence of individuals' working memory (RQ1. The review also considers metrics used to evaluate presentational choices, and types of presentational choices considered. As for presentational choices (RQ2, we consider a number of variants including interactivity, aggregation, layout, and emphasis. Finally, to evaluate the effectiveness of plan presentational choices (RQ3 we adopt a layered-evaluation approach and measure performance in a dual task paradigm, involving both task interleaving and evaluation of situational awareness. This novel methodology for evaluating visualizations is employed in a series of experiments investigating presentational choices for a plan. A key finding is that emphasizing steps (by highlighting borders can improve effectiveness on a primary task, but only when controlling for individual variation in working memory.

Personalizing mechanical ventilation for acute respiratory distress syndrome

OpenAIRE

Berngard, S. Clark; Beitler, Jeremy R.; Malhotra, Atul

2016-01-01

Lung-protective ventilation with low tidal volumes remains the cornerstone for treating patient with acute respiratory distress syndrome (ARDS). Personalizing such an approach to each patient's unique physiology may improve outcomes further. Many factors should be considered when mechanically ventilating a critically ill patient with ARDS. Estimations of transpulmonary pressures as well as individual's hemodynamics and respiratory mechanics should influence PEEP decisions as well as response ...

Respiratory problems in patients with ectodermal dysplasia syndromes.

Science.gov (United States)

Fete, Timothy

2014-10-01

The ectodermal dysplasias (EDs) are a heterogeneous group of disorders characterized by a deficiency of ectoderm- and mesoderm-derived tissues and appendages, particularly hair, skin, teeth, and nails. Many of these disorders are associated with a greater risk of respiratory disease than found in the general population. There are no published papers that comprehensively describe these findings and the possible etiologies. Patients have been reported with dramatic decrease in mucous glands in the respiratory tract. Anatomic defects, including cleft palate, that predispose to respiratory infection, are associated with several of the ED syndromes. Atopy and immune deficiencies have been shown to have a higher prevalence in ED syndromes. Clinicians who care for patients affected by ED syndromes should be aware of the potential respiratory complications, and consider evaluation for structural anomalies, atopy and immunodeficiency in individuals with recurrent or chronic respiratory symptoms. © 2014 Wiley Periodicals, Inc.

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.

Individual differences in detecting rapidly presented fearful faces.

Directory of Open Access Journals (Sweden)

Dandan Zhang

Full Text Available Rapid detection of evolutionarily relevant threats (e.g., fearful faces is important for human survival. The ability to rapidly detect fearful faces exhibits high variability across individuals. The present study aimed to investigate the relationship between behavioral detection ability and brain activity, using both event-related potential (ERP and event-related oscillation (ERO measurements. Faces with fearful or neutral facial expressions were presented for 17 ms or 200 ms in a backward masking paradigm. Forty-two participants were required to discriminate facial expressions of the masked faces. The behavioral sensitivity index d' showed that the detection ability to rapidly presented and masked fearful faces varied across participants. The ANOVA analyses showed that the facial expression, hemisphere, and presentation duration affected the grand-mean ERP (N1, P1, and N170 and ERO (below 20 Hz and lasted from 100 ms to 250 ms post-stimulus, mainly in theta band brain activity. More importantly, the overall detection ability of 42 subjects was significantly correlated with the emotion effect (i.e., fearful vs. neutral on ERP (r = 0.403 and ERO (r = 0.552 measurements. A higher d' value was corresponding to a larger size of the emotional effect (i.e., fearful--neutral of N170 amplitude and a larger size of the emotional effect of the specific ERO spectral power at the right hemisphere. The present results suggested a close link between behavioral detection ability and the N170 amplitude as well as the ERO spectral power below 20 Hz in individuals. The emotional effect size between fearful and neutral faces in brain activity may reflect the level of conscious awareness of fearful faces.

Evaluation of respiratory pattern during respiratory-gated radiotherapy

International Nuclear Information System (INIS)

Dobashi, Suguru; Mori, Shinichiro

2014-01-01

The respiratory cycle is not strictly regular, and generally varies in amplitude and period from one cycle to the next. We evaluated the characteristics of respiratory patterns acquired during respiratory gating treatment in more than 300 patients. A total 331 patients treated with respiratory-gated carbon-ion beam therapy were selected from a group of patients with thoracic and abdominal conditions. Respiratory data were acquired for a total of 3,171 fractions using an external respiratory sensing monitor and evaluated for respiratory cycle, duty cycle, magnitude of baseline drift, and intrafractional/interfractional peak inhalation/exhalation positional variation. Results for the treated anatomical sites and patient positioning were compared. Mean ± SD respiratory cycle averaged over all patients was 4.1 ± 1.3 s. Mean ± SD duty cycle averaged over all patients was 36.5 ± 7.3 %. Two types of baseline drift were seen, the first decremental and the second incremental. For respiratory peak variation, the mean intrafractional variation in peak-inhalation position relative to the amplitude in the first respiratory cycle (15.5 ± 9.3 %) was significantly larger than that in exhalation (7.5 ± 4.6 %). Interfractional variations in inhalation (17.2 ± 18.5 %) were also significantly greater than those in exhalation (9.4 ± 10.0 %). Statistically significant differences were observed between patients in the supine position and those in the prone position in mean respiratory cycle, duty cycle, and intra-/interfractional variations. We quantified the characteristics of the respiratory curve based on a large number of respiratory data obtained during treatment. These results might be useful in improving the accuracy of respiratory-gated treatment.

Respiratory muscle involvement in sarcoidosis.

Science.gov (United States)

Schreiber, Tina; Windisch, Wolfram

2018-07-01

In sarcoidosis, muscle involvement is common, but mostly asymptomatic. Currently, little is known about respiratory muscle and diaphragm involvement and function in patients with sarcoidosis. Reduced inspiratory muscle strength and/or a reduced diaphragm function may contribute to exertional dyspnea, fatigue and reduced health-related quality of life. Previous studies using volitional and non-volitional tests demonstrated a reduced inspiratory muscle strength in sarcoidosis compared to control subjects, and also showed that respiratory muscle function may even be significantly impaired in a subset of patients. Areas covered: This review examines the evidence on respiratory muscle involvement and its implications in sarcoidosis with emphasis on pathogenesis, diagnosis and treatment of respiratory muscle dysfunction. The presented evidence was identified by a literature search performed in PubMed and Medline for articles about respiratory and skeletal muscle function in sarcoidosis through to January 2018. Expert commentary: Respiratory muscle involvement in sarcoidosis is an underdiagnosed condition, which may have an important impact on dyspnea and health-related quality of life. Further studies are needed to understand the etiology, pathogenesis and extent of respiratory muscle involvement in sarcoidosis.

SMART phones and the acute respiratory patient.

LENUS (Irish Health Repository)

Gleeson, L

2012-05-01

Definition of Respiratory Failure using PaO2 alone is confounded when patients are commenced on oxygen therapy prior to arterial blood gas (ABG) measurement. Furthermore, classification of Respiratory Failure as Type 1 or Type 2 using PaCO2 alone can give an inaccurate account of events as both types can co-exist. 100 consecutive presentations of acute respiratory distress were assessed initially using PaO2, and subsequently PaO2\\/FiO2 ratio, to diagnose Respiratory Failure. Respiratory Failure cases were classified as Type 1 or Type 2 initially using PaCO2, and subsequently alveolar-arterial (A-a) gradient. Any resultant change in management was documented. Of 100 presentations, an additional 16 cases were diagnosed as Respiratory Failure using PaO2\\/FiO2 ratio in place of PaO2 alone (p = 0.0338). Of 57 cases of Respiratory Failure, 22 cases classified as Type 2 using PaCO2 alone were reclassified as Type 1 using A-a gradient (p < 0.001). Of these 22 cases, management changed in 18.

Carbon dioxide induces erratic respiratory responses in bipolar disorder.

Science.gov (United States)

Mackinnon, Dean F; Craighead, Brandie; Lorenz, Laura

2009-01-01

CO(2) respiration stimulates both anxiety and dyspnea ("air hunger") and has long been used to study panic vulnerability and respiratory control. High comorbidity with panic attacks suggests individuals with bipolar disorder may also mount a heightened anxiety response to CO(2). Moreover, problems in the arousal and modulation of appetites are central to the clinical syndromes of mania and depression; hence CO(2) may arouse an abnormal respiratory response to "air hunger". 72 individuals (34 bipolar I, 25 depressive and bipolar spectrum, 13 with no major affective diagnosis) breathed air and air with 5% CO(2) via facemask for up to 15 min each; subjective and respiratory responses were recorded. Nearly half the subjects diverged from the typical response to a fixed, mildly hypercapneic environment, which is to increase breathing acutely, and then maintain a hyperpneic plateau. The best predictors of an abnormal pattern were bipolar diagnosis and anxiety from air alone. 25 individuals had a panic response; panic responses from CO(2) were more likely in subjects with bipolar I compared to other subjects, however the best predictors of a panic response overall were anxiety from air alone and prior history of panic attacks. Heterogeneous sample, liberal definition of panic attack. Carbon dioxide produces abnormal respiratory and heightened anxiety responses among individuals with bipolar and depressive disorders. These may be due to deficits in emotional conditioning related to fear and appetite. Although preliminary, this work suggests a potentially useful test of a specific functional deficit in bipolar disorder.

The Respiratory Presentation of Severe Combined Immunodeficiency in Two Mennonite Children at a Tertiary Centre Highlighting the Importance of Recognizing This Pediatric Emergency

Directory of Open Access Journals (Sweden)

Simon Lam

2014-01-01

Full Text Available Severe combined immunodeficiency (SCID is considered to be a pediatric emergency, with respiratory distress being the most common presenting symptom. The authors present two cases of SCID in children <4 months of age with respiratory distress at a tertiary care centre due to a recently described homozygous CD3 delta mutation found only in the Mexican Mennonite population. Failure to respond to broad-spectrum antibiotics prompted investigation for possible SCID. Bronchial alveolar lavage fluid from both patients grew Pneumocystis jiroveci, and flow cytometry revealed absent T cells. The CD3 delta gene is believed to be important in T cell differentiation and maturation. The present article reminds pediatricians and pediatric respirologists that the key to diagnosing SCID is to have a high index of suspicion if there is poor response to conventional therapies.

Heliox reduces respiratory system resistance in respiratory syncytial virus induced respiratory failure

NARCIS (Netherlands)

Kneyber, Martin C. J.; van Heerde, Marc; Twisk, Jos W. R.; Plotz, Frans B.; Markhors, Dick G.

2009-01-01

Introduction Respiratory syncytial virus (RSV) lower respiratory tract disease is characterised by narrowing of the airways resulting in increased airway resistance, air-trapping and respiratory acidosis. These problems might be overcome using helium-oxygen gas mixture. However, the effect of

Heliox reduces respiratory system resistance in respiratory syncytial virus induced respiratory failure

NARCIS (Netherlands)

Kneijber, M.C.J.; van Heerde, M.; Twisk, J.W.R.; Plotz, F.; Markhorst, D.G.

2009-01-01

Introduction: Respiratory syncytial virus (RSV) lower respiratory tract disease is characterised by narrowing of the airways resulting in increased airway resistance, air-trapping and respiratory acidosis. These problems might be overcome using helium-oxygen gas mixture. However, the effect of

Lung-Protective Ventilation With Low Tidal Volumes and the Occurrence of Pulmonary Complications in Patients Without Acute Respiratory Distress Syndrome: A Systematic Review and Individual Patient Data Analysis

NARCIS (Netherlands)

Neto, Ary Serpa; Simonis, Fabienne D.; Barbas, Carmen S. V.; Biehl, Michelle; Determann, Rogier M.; Elmer, Jonathan; Friedman, Gilberto; Gajic, Ognjen; Goldstein, Joshua N.; Linko, Rita; Pinheiro de Oliveira, Roselaine; Sundar, Sugantha; Talmor, Daniel; Wolthuis, Esther K.; Gama de Abreu, Marcelo; Pelosi, Paolo; Schultz, Marcus J.

2015-01-01

Protective mechanical ventilation with low tidal volumes is standard of care for patients with acute respiratory distress syndrome. The aim of this individual patient data analysis was to determine the association between tidal volume and the occurrence of pulmonary complications in ICU patients

The Burden and Clinical Presentation of Pulmonary Tuberculosis in Adults With Severe Respiratory Illness in a High Human Immunodeficiency Virus Prevalence Setting, 2012-2014.

Science.gov (United States)

Walaza, Sibongile; Tempia, Stefano; Dreyer, Andries; Dawood, Halima; Variava, Ebrahim; Martinson, Neil A; Moyes, Jocelyn; Cohen, Adam L; Wolter, Nicole; von Mollendorf, Claire; von Gottberg, Anne; Haffejee, Sumayya; Treurnicht, Florette; Hellferscee, Orienka; Ismail, Nazir; Cohen, Cheryl

2017-01-01

Understanding the burden and clinical presentation of tuberculosis in patients with severe respiratory illness (SRI) has important implications for anticipating treatment requirements. Hospitalized patients aged ≥15 years with SRI at 2 public teaching hospitals in periurban areas in 2 provinces (Edendale Hospital in Pietermaritzburg, KwaZulu-Natal Province and Tshepong Hospital in Klerksdorp, North West Province) were enrolled prospectively from 2012 to 2014. Tuberculosis testing included smear microscopy, culture, or Xpert MTB/Rif. We enrolled 2486 individuals with SRI. Of these, 2097 (84%) were tested for tuberculosis, 593 (28%) were positive. Tuberculosis detection rate was 18% (133 of 729) in individuals with acute (≤14 days) presentation and 34% (460 of 1368) in those with chronic (>14 days) presentation. Among laboratory-confirmed tuberculosis cases, those with acute presentation were less likely to present with cough (88% [117 of 133] vs 97% [447 of 460]; ajusted odds ratio [aOR] = 0.2, 95% confidence interval [CI] = 0.1-0.5), night sweats (57% [75 of 132] vs 73% [337 of 459]; aOR = 0.4, 95% CI = 0.3-0.7), or be started on tuberculosis treatment on admission (63% [78 of 124] vs 81% [344 of 423]; aOR = 0.4, 95% CI = 0.3-0.7), but they were more likely to be coinfected with pneumococcus (13% [16 of 124] vs 6% [26 of 411]; aOR 2.3, 95% CI 1.3-5.3) than patients with chronic presentation. Annual incidence of acute and chronic tuberculosis-associated SRI per 100000 population was 28 (95% CI = 22-39) and 116 (95% CI = 104-128), respectively. In this setting, tuberculosis, including acute presentation, is common in patients hospitalized with SRI.

Pattern of respiratory diseases in children presenting to the paediatric emergency unit of the University of Nigeria Teaching Hospital, Enugu: a case series report.

Science.gov (United States)

Oguonu, Tagbo; Adaeze Ayuk, Chikaodinaka; Edelu, Benedict Onyeka; Ndu, Ikenna Kingsley

2014-06-10

Respiratory diseases are one of the causes of childhood morbidity and mortality as well as hospitalization globally. The patterns of different respiratory illnesses in several parts of the world have been reported but there are few on the combined burden of the diseases. Determination of the burden of respiratory diseases as a group will help ascertain their collective impact on the health systems in order to develop intervention measures. Data from case notes of children with respiratory diseases admitted to the University of Nigeria Teaching Hospital Enugu, Nigeria over a six year period were extracted. Age, gender, admission rates, types of respiratory illness, duration of admission, season of presentation and outcome were analysed. Descriptive and inferential (Chi square) statistics were used to describe the various disease types and ascertain association of the disease outcome, seasonal pattern with the types of diseases. Of the total of 8974 children admissions, 2214 (24.7%) were due to respiratory diseases. The mean age of all the children with respiratory diseases was 3.3 years (SD 3.9). Communicable diseases were the common cause of admission cases throughout the seasons, p < 0.001. The highest admission rates were for pneumonia, (34.0%), acute bronchial asthma, (27.7%) and rhinosinusitis (14.6%) p < 0.001. The frequency of respiratory disease decreases with age and children less than five years of age and of low socio-economic status were commonly affected, p=0.01. The median duration of hospital stay was two days [range 1 to 8 days], children less than five years old and those of low socio-economic status, spent more than four days (p=0.01 and p < 0.001 respectively). The all-cause mortality was 0.5% (11/2214) of which 81.8% (9/11) was due to pneumonia. Respiratory diseases constitute a significant burden of childhood illnesses in our centre. Efforts are required to reduce the impact as part of the steps towards the achievement of the Millennium

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...

Prevention of Respiratory Distress After Laparoscopic Cholecystectomy

Directory of Open Access Journals (Sweden)

O. A. Dolina

2005-01-01

Full Text Available The paper presents the results of a comparative study of different methods for preventing respiratory distress after laparoscopic cholecystectomy. It shows the advantages of use of noninvasive assisted ventilation that ensures excessive positive pressure in the respiratory contour, its impact on external respiratory function, arterial blood gases, oxygen transport and uptake. A scheme for the prevention of respiratory diseases applying noninvasive assisted ventilation is given.

[Respiratory handicap. Recognition, evaluation and social benefits].

Science.gov (United States)

Marsac, J; Pujet, J C

1983-01-01

The medico-social aspects of respiratory handicap pose some perplexing problems, notably in their recognition, rigorous evaluation and in the granting of social security benefits. The clinical and respiratory function data should be standardised and classified according to type and significance of respiratory disease and also according to the degree of co-operation and understanding of the patient. The respiratory handicap should be evaluated after considering the functional disability engendered by the disorder and their socio-professional repercussions. The abnormality in the lungs should be measured by resting tests; the degree of disability by exercise studies; the socio-professional handicap by ergonometric tests to assess the scale of the demands and requirements of family and social and professional life, indeed the cultural and economic style of the individual concerned. Such combined studies would enable recognition of severe chronic respiratory handicap leading to decisions for exemption certificates, such as cases of severe respiratory failure in patients requiring supplementary treatment for oxygen therapy or assisted ventilation. The benefits and grants offered to those with respiratory handicaps would involve a number of rights relating to: care, work, costs of replacement of workers in the event of prolonged sick leave or the benefits of an invalidity pension. There will be other allowances such as invalidity cards, lodging special studies and other rights particularly relating to lodging and special equipment. The present scale is difficult to use both because of its lack of specificity and its ill-chosen terminology. For better balance between the handicap and the benefits offered, a common and more flexible system, with a printed table should be at hand for the doctor to use for certain decisions: long term illness, period of invalidity or early retirement because of medical incapacity. Within each table a sub-section should exist to allow for

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.

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.

Inactivity-induced respiratory plasticity: Protecting the drive to breathe in disorders that reduce respiratory neural activity☆

Science.gov (United States)

Strey, K.A.; Baertsch, N.A.; Baker-Herman, T.L.

2013-01-01

Multiple forms of plasticity are activated following reduced respiratory neural activity. For example, in ventilated rats, a central neural apnea elicits a rebound increase in phrenic and hypoglossal burst amplitude upon resumption of respiratory neural activity, forms of plasticity called inactivity-induced phrenic and hypoglossal motor facilitation (iPMF and iHMF), respectively. Here, we provide a conceptual framework for plasticity following reduced respiratory neural activity to guide future investigations. We review mechanisms giving rise to iPMF and iHMF, present new data suggesting that inactivity-induced plasticity is observed in inspiratory intercostals (iIMF) and point out gaps in our knowledge. We then survey conditions relevant to human health characterized by reduced respiratory neural activity and discuss evidence that inactivity-induced plasticity is elicited during these conditions. Understanding the physiological impact and circumstances in which inactivity-induced respiratory plasticity is elicited may yield novel insights into the treatment of disorders characterized by reductions in respiratory neural activity. PMID:23816599

The Burden and Clinical Presentation of Pulmonary Tuberculosis in Adults With Severe Respiratory Illness in a High Human Immunodeficiency Virus Prevalence Setting, 2012–2014

Science.gov (United States)

Tempia, Stefano; Dreyer, Andries; Dawood, Halima; Variava, Ebrahim; Martinson, Neil A.; Moyes, Jocelyn; Cohen, Adam L.; Wolter, Nicole; von Mollendorf, Claire; von Gottberg, Anne; Haffejee, Sumayya; Treurnicht, Florette; Hellferscee, Orienka; Ismail, Nazir; Cohen, Cheryl

2017-01-01

Abstract Background Understanding the burden and clinical presentation of tuberculosis in patients with severe respiratory illness (SRI) has important implications for anticipating treatment requirements. Methods Hospitalized patients aged ≥15 years with SRI at 2 public teaching hospitals in periurban areas in 2 provinces (Edendale Hospital in Pietermaritzburg, KwaZulu-Natal Province and Tshepong Hospital in Klerksdorp, North West Province) were enrolled prospectively from 2012 to 2014. Tuberculosis testing included smear microscopy, culture, or Xpert MTB/Rif. Results We enrolled 2486 individuals with SRI. Of these, 2097 (84%) were tested for tuberculosis, 593 (28%) were positive. Tuberculosis detection rate was 18% (133 of 729) in individuals with acute (≤14 days) presentation and 34% (460 of 1368) in those with chronic (>14 days) presentation. Among laboratory-confirmed tuberculosis cases, those with acute presentation were less likely to present with cough (88% [117 of 133] vs 97% [447 of 460]; ajusted odds ratio [aOR] = 0.2, 95% confidence interval [CI] = 0.1–0.5), night sweats (57% [75 of 132] vs 73% [337 of 459]; aOR = 0.4, 95% CI = 0.3–0.7), or be started on tuberculosis treatment on admission (63% [78 of 124] vs 81% [344 of 423]; aOR = 0.4, 95% CI = 0.3–0.7), but they were more likely to be coinfected with pneumococcus (13% [16 of 124] vs 6% [26 of 411]; aOR 2.3, 95% CI 1.3–5.3) than patients with chronic presentation. Annual incidence of acute and chronic tuberculosis-associated SRI per 100000 population was 28 (95% CI = 22–39) and 116 (95% CI = 104–128), respectively. Conclusions In this setting, tuberculosis, including acute presentation, is common in patients hospitalized with SRI. PMID:28852676

Global Considerations in Human Immunodeficiency Virus-Associated Respiratory Disease.

Science.gov (United States)

Rylance, Jamie; Meghji, Jamilah; Miller, Robert F; Ferrand, Rashida A

2016-04-01

Respiratory tract infection, particularly tuberculosis, is a major cause of mortality among human immunodeficiency virus (HIV)-infected individuals. Antiretroviral therapy (ART) has resulted in a dramatic increase in survival, although coverage of HIV treatment remains low in many parts of the world. There is a concurrent growing burden of chronic noninfectious respiratory disease as a result of increased survival. Many risk factors associated with the development of respiratory disease, such as cigarette smoking and intravenous drug use, are overrepresented among people living with HIV. In addition, there is emerging evidence that HIV infection may directly cause or accelerate the course of chronic lung disease. This review summarizes the clinical spectrum and epidemiology of respiratory tract infections and noninfectious pulmonary pathologies, and factors that explain the global variation in HIV-associated respiratory disease. The potential for enhancing diagnoses of noninfective chronic conditions through the use of clinical algorithms is discussed. We also consider issues in assessment and management of HIV-related respiratory disease in view of the increasing global scale up of ART. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

A case of severe and rigid congenital thoracolumbar lordoscoliosis with diastematomyelia presenting with type 2 respiratory failure: managed by staged correction with controlled axial traction.

Science.gov (United States)

Kanagaraju, Vijayanth; Chhabra, H S; Srivastava, Abhishek; Mahajan, Rajat; Kaul, Rahul; Bhatia, Pallav; Tandon, Vikas; Nanda, Ankur; Sangondimath, Gururaj; Patel, Nishit

2016-10-01

Congenital lordoscoliosis is an uncommon pathology and its management poses formidable challenge especially in the presence of type 2 respiratory failure and intraspinal anomalies. In such patients standard management protocols are not applicable and may require multistage procedure to minimize risk and optimize results. A 15-year-old girl presented in our hospital emergency services with severe breathing difficulty. She had a severe and rapidly progressing deformity in her back, noted since 6 years of age, associated with severe respiratory distress requiring oxygen and BiPAP support. She was diagnosed to have a severe and rigid congenital right thoracolumbar lordoscoliosis (coronal Cobb's angle: 105° and thoracic lordosis -10°) with type 1 split cord malformation with bony septum extending from T11 to L3. This leads to presentation of restrictive lung disease with type 2 respiratory failure. As her lung condition did not allow for any major procedure, we did a staged procedure rather than executing in a single stage. Controlled axial traction by halogravity was applied initially followed by halo-femoral traction. Four weeks later, this was replaced by halo-pelvic distraction device after a posterior release procedure with asymmetric pedicle substraction osteotomies at T7 and T10. Halo-pelvic distraction continued for 4 more weeks to optimize and correct the deformity. Subsequently definitive posterior stabilization and fusion was done. The detrimental effect of diastematomyelia resection in such cases is clearly evident from literature, so it was left unresected. A good scoliotic correction with improved respiratory function was achieved. Three years follow-up showed no loss of deformity correction, no evidence of pseudarthrosis and a good clinical outcome with reasonably balanced spine. The management of severe and rigid congenital lordoscoliotic deformities with intraspinal anomalies is challenging. Progressive reduction in respiratory volume in untreated

Triggering of acute myocardial infarction by respiratory infection.

Science.gov (United States)

Ruane, Lorcan; Buckley, Thomas; Hoo, Soon Y S; Hansen, Peter S; McCormack, Catherine; Shaw, Elizabeth; Fethney, Judith; Tofler, Geoffrey H

2017-05-01

Respiratory infection has been associated with an increased short-term risk of myocardial infarction (MI). However, previous studies have predominantly been conducted without angiographic confirmation of MI. The possibility can therefore not be excluded that raised troponin levels or electrocardiogram abnormalities that may be seen with respiratory infections are due to non-ischaemic causes. To investigate the association between respiratory infection and angiographically confirmed MI. Interviews were conducted within 4 days of hospitalisation in 578 patients with angiographically confirmed MI, to assess for recent exposure to respiratory infection symptoms and the usual annual frequency of these symptoms. Using case-crossover methodology, exposure to respiratory infection prior to the onset of MI was compared against the usual frequency of exposure in the past year. Symptoms of respiratory infection were reported by 100 (17%) and 123 (21%) within 7 and 35 days, respectively, prior to MI. The relative risk (RR) for MI occurring within 1-7 days after respiratory infection symptoms was 17.0 (95% confidence interval (CI) 13.2-21.8), and declined with subsequent time periods. In a subgroup analysis, the RR tended to be lower in groups taking regular cardiac medications. For those who reported milder, upper respiratory tract infection symptoms, the RR for the 1-7-day time period was 13.5 (95% CI 10.2-17.7). These findings confirm that respiratory infection can trigger MI. Further study is indicated to identify treatment strategies to decrease this risk, particularly in individuals who may have increased susceptibility. © 2017 Royal Australasian College of Physicians.

Always Consider the Possibility of Opioid Induced Respiratory Depression in Patients Presenting with Hypercapnic Respiratory Failure Who Fail to Improve as Expected with Appropriate Therapy

Directory of Open Access Journals (Sweden)

Martin Steynor

2015-01-01

Full Text Available Hypercapnic respiratory failure is a frequently encountered medical emergency. Two common causes are acute exacerbations of chronic obstructive pulmonary disease (COPD and as a side effect of opioids. The two causes may coexist leading to diagnostic confusion and consequent delay in optimal management. We report a case of what was initially thought to be an exacerbation of COPD. The patient failed to improve with treatment as expected which led to the empirical administration of naloxone resulting in a dramatic reversal of her respiratory failure. The patient was subsequently discovered to be taking regular dihydrocodeine for chronic back pain.

Personalizing mechanical ventilation for acute respiratory distress syndrome.

Science.gov (United States)

Berngard, S Clark; Beitler, Jeremy R; Malhotra, Atul

2016-03-01

Lung-protective ventilation with low tidal volumes remains the cornerstone for treating patient with acute respiratory distress syndrome (ARDS). Personalizing such an approach to each patient's unique physiology may improve outcomes further. Many factors should be considered when mechanically ventilating a critically ill patient with ARDS. Estimations of transpulmonary pressures as well as individual's hemodynamics and respiratory mechanics should influence PEEP decisions as well as response to therapy (recruitability). This summary will emphasize the potential role of personalized therapy in mechanical ventilation.

Increased concordance of severe respiratory syncytial virus infection in identical twins

DEFF Research Database (Denmark)

Thomsen, Simon Francis; Stensballe, Lone Graff; Skytthe, Axel

2008-01-01

(concordance rate: 0.66 vs 0.53), which suggests genetic influences on disease severity. Genetic factors accounted for 16%, family environment for 73%, and nonshared environment for 11% of the individual susceptibility to develop severe respiratory syncytial virus infection. CONCLUSIONS: The severity...... of respiratory syncytial virus infection is determined partly by genetic factors. This result should stimulate the search for genetic markers of disease severity.......OBJECTIVE: We estimated differences in the severity of respiratory syncytial virus infection attributable to genetic and environmental factors. METHODS: Record linkage data on hospitalizations attributable to respiratory syncytial virus infection were gathered on all twins (12,346 pairs) born...

Respiratory processes in non-photosynthetic plastids

Science.gov (United States)

Renato, Marta; Boronat, Albert; Azcón-Bieto, Joaquín

2015-01-01

Chlororespiration is a respiratory process located in chloroplast thylakoids which consists in an electron transport chain from NAD(P)H to oxygen. This respiratory chain involves the NAD(P)H dehydrogenase complex, the plastoquinone pool and the plastid terminal oxidase (PTOX), and it probably acts as a safety valve to prevent the over-reduction of the photosynthetic machinery in stress conditions. The existence of a similar respiratory activity in non-photosynthetic plastids has been less studied. Recently, it has been reported that tomato fruit chromoplasts present an oxygen consumption activity linked to ATP synthesis. Etioplasts and amyloplasts contain several electron carriers and some subunits of the ATP synthase, so they could harbor a similar respiratory process. This review provides an update on the study about respiratory processes in chromoplasts, identifying the major gaps that need to be addressed in future research. It also reviews the proteomic data of etioplasts and amyloplasts, which suggest the presence of a respiratory electron transport chain in these plastids. PMID:26236317

Respiratory processes in non-photosynthetic plastids

Directory of Open Access Journals (Sweden)

Marta eRenato

2015-07-01

Full Text Available Chlororespiration is a respiratory process located in chloroplast thylakoids which consists in an electron transport chain from NAD(PH to oxygen. This respiratory chain involves the NAD(PH dehydrogenase complex, the plastoquinone pool and the plastid terminal oxidase (PTOX, and it probably acts as a safety valve to prevent the over-reduction of the photosynthetic machinery in stress conditions. The existence of a similar respiratory activity in non-photosynthetic plastids has been less studied. Recently, it has been reported that tomato fruit chromoplasts present an oxygen consumption activity linked to ATP synthesis. Etioplasts and amyloplasts contain several electron carriers and some subunits of the ATP synthase, so they could harbor a similar respiratory process. This review provides an update on the study about respiratory processes in chromoplasts, identifying the major gaps that need to be addressed in future research. It also reviews the proteomic data of etioplasts and amyloplasts, which suggest the presence of a respiratory electron transport chain in these plastids.

Inhaled nitric oxide for acute respiratory distress syndrome (ARDS) in children and adults

DEFF Research Database (Denmark)

Gebistorf, Fabienne; Karam, Oliver; Wetterslev, Jørn

2016-01-01

BACKGROUND: Acute hypoxaemic respiratory failure (AHRF) and mostly acute respiratory distress syndrome (ARDS) are critical conditions. AHRF results from several systemic conditions and is associated with high mortality and morbidity in individuals of all ages. Inhaled nitric oxide (INO) has been...

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

Science.gov (United States)

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

2015-07-01

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. 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. Airway obstruction increased the within-breath respiratory impedance parameters that were significantly correlated with the spirometric indices of airway obstruction (R=-0.65, pdisease patients presented significant expiratory-inspiratory differences (p90%). 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.

Everything that wheezes… Late presentation of an aspirated foreign body as a cause of near fatal respiratory distress

OpenAIRE

L. Hindle*

2013-01-01

Aspirated foreign bodies are a common cause of mortality in children. They can be difficult to diagnose if the aspiration is not witnessed or if the object is not radiopaque, as this case illustrates. Case report: A 4 year old boy with a history of previous TB presented with respiratory distress after a week of fever and cough. No history of choking or foreign body was elicited. On examination the child was distressed, hypoxic and febrile. On auscultation bilateral coarse crackles and an e...

Respiratory acidosis

Science.gov (United States)

Ventilatory failure; Respiratory failure; Acidosis - respiratory ... Causes of respiratory acidosis include: Diseases of the airways (such as asthma and COPD ) Diseases of the lung tissue (such as ...

Human metapneumovirus and respiratory syncytial virus in hospitalized danish children with acute respiratory tract infection

DEFF Research Database (Denmark)

von Linstow, Marie-Louise; Larsen, Hans Henrik; Eugen-Olsen, Jesper

2004-01-01

The newly discovered human metapneumovirus (hMPV) has been shown to be associated with respiratory illness. We determined the frequencies and clinical features of hMPV and respiratory syncytial virus (RSV) infections in 374 Danish children with 383 episodes of acute respiratory tract infection...... children 1-6 months of age. Asthmatic bronchitis was diagnosed in 66.7% of hMPV and 10.6% of RSV-infected children (p infected children required respiratory support. hMPV is present in young.......6%) ARTI episodes by real-time reverse transcription-polymerase chain reaction using primers targeting the hMPV N gene and the RSV L gene. Two children were co-infected with hMPV and RSV. They were excluded from statistical analysis. Hospitalization for ARTI caused by hMPV was restricted to very young...

A respiratory monitoring device based on clavicular motion

International Nuclear Information System (INIS)

Pitts, D G; Aspinall, R; Patel, M K; Lang, P-O; Sinclair, A J

2013-01-01

Respiratory rate is one of the key vital signs yet unlike temperature, heart rate or blood pressure, there is no simple and low cost measurement device for medical use. Here we discuss the development of a respiratory sensor based upon clavicular motion and the findings of a pilot study comparing respiratory rate readings derived from clavicular and thoracic motion with an expiratory breath flow reference sensor. Simultaneously sampled data from resting volunteers (n = 8) was analysed to determine the location of individual breaths in the data set and from these, breath periods and frequency were calculated. Clavicular sensor waveforms were found to be more consistent and of greater amplitude than those from the thoracic device, demonstrating good alignment with the reference waveform. On comparing breath by breath periods a close agreement was observed with the reference, with mean clavicular respiratory rate R 2 values of 0.89 (lateral) and 0.98 (longitudinal-axis). This pilot study demonstrates the viability of clavicular respiratory sensing. The sensor is unobtrusive, unaffected by bioelectrical or electrode problems and easier to determine and more consistent than thoracic motion sensing. With relatively basic signal conditioning and processing requirements, it could provide an ideal platform for a low-cost respiratory monitor. (note)

Antibody Tracing, Seroepidemiology and Risk Factors of Bovine Respiratory Syncytial Virus and Bovine Adenovirus-3 in Dairy Holstein Farms

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Mahsa FARZINPOUR

2016-01-01

Full Text Available Antibody tracing, risk factors and seroepidemiology of bovine respiratory syncytial virus and bovine adenovirus-3 were investigated in 22 Industrial and Semi-Industrial dairy Holstein farms. Serum samples (n=736 from various ages of unvaccinated cows were collected from May to September 2012. Risk factors including age, past history of respiratory diseases, amount of milk production, husbandry type and herd size were considered. Data were analyzed by Chi-square and logistic regression. Results indicated that the infection with some of individual viruses was related to past history of respiratory disease and herd size. No specific pattern was seen on the effect of level of milk production on seropositivity of animals. The seroprevalence for BRSV and BAV-3 were 89.1% and 88%, respectively. The present study indicates that infections of bovine respiratory viruses frequently occur in cattle of Fars province and the main viral cause of primary occurrence of respiratory diseases may be due to aforementioned viruses.

Pulmonary fibrosis secondary to siderosis causing symptomatic respiratory disease: a case report.

Science.gov (United States)

McCormick, Liam M; Goddard, Martin; Mahadeva, Ravi

2008-08-05

Pulmonary siderosis secondary to the inhalation of iron compounds is a rare condition which, despite striking radiological and histopathological features, has not traditionally been associated with symptoms or functional impairment. Although not the first of its kind, we present an unusual case of pulmonary siderosis with symptomatic respiratory disease, most likely secondary to associated fibrosis. A 66-year-old Caucasian man was referred to the outpatient clinic with a 2-year history of exertional breathlessness. He had worked as an engineer for 20 years where he did a significant amount of welding but always wore a face shield. Clinical, radiological and histological features were consistent with a diagnosis of pulmonary siderosis, with associated fibrosis, most likely related to his occupational welding history. Our report illustrates that symptomatic respiratory disease due to mild peribronchiolar fibrosis can occur with pulmonary siderosis despite wearing a mask. Furthermore, it reinforces the need for all clinicians to compile a detailed occupational history in individuals presenting with breathlessness.

Tricky typhus ticks two: A report of two sisters from North India presenting with acute respiratory distress syndrome due to scrub typhus

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R Pai

2016-01-01

Full Text Available Scrub typhus is emerging as an important cause of acute febrile illness in Northern India. This is a report of two sisters presenting concurrently with acute respiratory distress syndrome. A diagnosis of scrub typhus was made in both the patients, and they were successfully treated with doxycycline.

Two Cases of Arnold-Chiari Malformation with Respiratory Failure

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Sinem Iliaz

2014-03-01

Full Text Available Arnold–Chiari malformation is defined as downward displacement of the brainstem and cerebellum through the foramen magnum. It has different clinical presentations and four subtypes. It is known that downward migration of posterior fossa components through the foramen magnum and associated lower cranial nerve palsy and brainstem compression can cause respiratory failure. Acute respiratory failure could mark the onset of the disease. Posterior fossa decompression performed to treat primary disease can improve the central sleep abnormalities. As respiratory failure is rarely seen, this paper presents two cases of Arnold–Chiari malformation with respiratory failure.

Air pollution in India and related adverse respiratory health effects: past, present, and future directions.

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Khilnani, Gopi C; Tiwari, Pawan

2018-03-01

The review describes current status of air pollution in India, summarizes recent research on adverse health effects of ambient and household air pollution, and outlines the ongoing efforts and future actions required to improve air quality and reduce morbidity and mortality because of air pollution in India. Global burden of disease data analysis reveals more than one million premature deaths attributable to ambient air pollution in 2015 in India. More than one million additional deaths can be attributed to household air pollution. Particulate matter with diameter 2.5 μm or less has been causatively linked with most premature deaths. Acute respiratory tract infections, asthma, chronic obstructive pulmonary disease, exacerbations of preexisting obstructive airway disease and lung cancer are proven adverse respiratory effects of air pollution. Targeting air quality standards laid by WHO can significantly reduce morbidity and mortality because of air pollution in India. India is currently exposed to high levels of ambient and household air pollutants. Respiratory adverse effects of air pollution are significant contributors to morbidity and premature mortality in India. Substantial efforts are being made at legislative, administrative, and community levels to improve air quality. However, much more needs to be done to change the 'status quo' and attain the target air quality standards. VIDEO ABSTRACT: http://links.lww.com/COPM/A24.

Human respiratory syncytial virus load normalized by cell quantification as predictor of acute respiratory tract infection.

Science.gov (United States)

Gómez-Novo, Miriam; Boga, José A; Álvarez-Argüelles, Marta E; Rojo-Alba, Susana; Fernández, Ana; Menéndez, María J; de Oña, María; Melón, Santiago

2018-05-01

Human respiratory syncytial virus (HRSV) is a common cause of respiratory infections. The main objective is to analyze the prediction ability of viral load of HRSV normalized by cell number in respiratory symptoms. A prospective, descriptive, and analytical study was performed. From 7307 respiratory samples processed between December 2014 to April 2016, 1019 HRSV-positive samples, were included in this study. Low respiratory tract infection was present in 729 patients (71.54%). Normalized HRSV load was calculated by quantification of HRSV genome and human β-globin gene and expressed as log10 copies/1000 cells. HRSV mean loads were 4.09 ± 2.08 and 4.82 ± 2.09 log10 copies/1000 cells in the 549 pharyngeal and 470 nasopharyngeal samples, respectively (P respiratory tract infection and 4.22 ± 2.28 log10 copies/1000 cells with upper respiratory tract infection or febrile syndrome (P < 0.05). A possible cut off value to predict LRTI evolution was tentatively established. Normalization of viral load by cell number in the samples is essential to ensure an optimal virological molecular diagnosis avoiding that the quality of samples affects the results. A high viral load can be a useful marker to predict disease progression. © 2018 Wiley Periodicals, Inc.

Pulmonary fibrosis secondary to siderosis causing symptomatic respiratory disease: a case report

Directory of Open Access Journals (Sweden)

McCormick Liam M

2008-08-01

Full Text Available Abstract Introduction Pulmonary siderosis secondary to the inhalation of iron compounds is a rare condition which, despite striking radiological and histopathological features, has not traditionally been associated with symptoms or functional impairment. Although not the first of its kind, we present an unusual case of pulmonary siderosis with symptomatic respiratory disease, most likely secondary to associated fibrosis. Case presentation A 66-year-old Caucasian man was referred to the outpatient clinic with a 2-year history of exertional breathlessness. He had worked as an engineer for 20 years where he did a significant amount of welding but always wore a face shield. Clinical, radiological and histological features were consistent with a diagnosis of pulmonary siderosis, with associated fibrosis, most likely related to his occupational welding history. Conclusion Our report illustrates that symptomatic respiratory disease due to mild peribronchiolar fibrosis can occur with pulmonary siderosis despite wearing a mask. Furthermore, it reinforces the need for all clinicians to compile a detailed occupational history in individuals presenting with breathlessness.

Respiratory alkalosis

Science.gov (United States)

Alkalosis - respiratory ... leads to shortness of breath can also cause respiratory alkalosis (such as pulmonary embolism and asthma). ... Treatment is aimed at the condition that causes respiratory alkalosis. Breathing into a paper bag -- or using ...

Respiratory allergy caused by house dust mites

DEFF Research Database (Denmark)

Calderón, Moisés A; Linneberg, Allan; Kleine-Tebbe, Jörg

2015-01-01

consequences in patients with respiratory allergic diseases. We investigate the epidemiology of HDM allergy to explore the interaction between mites and human subjects at the population, individual, and molecular levels. Core and recent publications were identified by using "house dust mite" as a key search...

Lifestyle factors and contact to general practice with respiratory alarm symptoms

DEFF Research Database (Denmark)

Sele, Lisa Maria Falk; Elnegaard, Sandra; Balasubramaniam, Kirubakaran

2016-01-01

BACKGROUND: A prerequisite for early lung cancer diagnosis is that individuals with respiratory alarm symptoms (RAS) contact a general practitioner (GP). This study aims to determine the proportion of individuals in the general population who contact a GP with RAS and to analyse the association...... between lifestyle factors and contact to GPs with RAS. METHODS: A web-based survey of 100 000 individuals randomly selected from the Danish Civil Registration System. Items regarding experience of RAS (prolonged coughing, shortness of breath, coughing up blood, and prolonged hoarseness), GP contacts......, and lifestyle factors (smoking status, alcohol intake, and body mass index) were included. RESULTS: In total 49 706 (52.5 %) individuals answered the questionnaire. Overall 7870 reported at least one respiratory alarm symptom, and of those 39.6 % (3 080) had contacted a GP. Regarding specific symptoms...

Comparison of respiratory functions of athletes engaged in different individual sports branches

OpenAIRE

Tülin Atan; Pelin Akyol; Mehmet Çebi

2013-01-01

Objectives: It was aimed to research pulmonary functionsof sedentary males and athletes who engaged in differentindividual sports branches in the same age group.Methods: 50 male athletes in 15-16 age group in the starcategory participated from each of the branches of judo,athletics, wrestling, taekwondo, table tennis and swimmingand 50 sedentary males participated as well; beingin total 350 subjects. Among respiratory functions tests;vital capacity (VC), forced vital capacity (FVC) and maximu...

Respiratory muscle strength of patients with esophagus and stomach neoplasms

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Evelyn Aline Boscolo Ruivo

Full Text Available Abstract Introduction: In cancer patients, the reduced food intake causes weight loss and promotes protein-calorie malnutrition. This results in loss of lean body mass, which affects both skeletal muscles and respiratory muscles. Objective: Evaluate and compare the respiratory muscle strength of patients with esophageal and stomach neoplasia during the preoperative period. Methods: This is a cross-sectional study carried out with 24 patients of both genders hospitalized in a teaching hospital. They underwent a physical therapy evaluation composed of anthropometric data and measurement of respiratory muscle strength through manovacuometry. Paired and unpaired t-tests were used to compare the values obtained with the predicted equations. Results: Regarding the disease prevalence, 66.66%(16 of the individuals had stomach neoplasm and 33.33%(8 esophageal neoplasm. Of the patients with esophageal neoplasm, 100% were men with a mean age of 63 ± 9.16 years. Of those with stomach neoplasm, 68.75% were men with a mean age of 69.36 ± 10.92 years. Female patients with stomach neoplasm had significantly higher BMI (p = 0.01 than male patients, and they were classified as overweight. Both neoplasms had significantly lower real values (p ≤ 0.05 than predicted values at the maximal expiratory pressure. Conclusion: Patients with esophageal and stomach neoplasms in the preoperative period present reduction in the expiratory muscle strength. There were no statistically significant differences, when we compared the maximum respiratory pressures between the two types of neoplasms investigated.

The clinical implementation of respiratory-gated intensity-modulated radiotherapy

International Nuclear Information System (INIS)

Keall, Paul; Vedam, Sastry; George, Rohini; Bartee, Chris; Siebers, Jeffrey; Lerma, Fritz; Weiss, Elisabeth; Chung, Theodore

2006-01-01

The clinical use of respiratory-gated radiotherapy and the application of intensity-modulated radiotherapy (IMRT) are 2 relatively new innovations to the treatment of lung cancer. Respiratory gating can reduce the deleterious effects of intrafraction motion, and IMRT can concurrently increase tumor dose homogeneity and reduce dose to critical structures including the lungs, spinal cord, esophagus, and heart. The aim of this work is to describe the clinical implementation of respiratory-gated IMRT for the treatment of non-small cell lung cancer. Documented clinical procedures were developed to include a tumor motion study, gated CT imaging, IMRT treatment planning, and gated IMRT delivery. Treatment planning procedures for respiratory-gated IMRT including beam arrangements and dose-volume constraints were developed. Quality assurance procedures were designed to quantify both the dosimetric and positional accuracy of respiratory-gated IMRT, including film dosimetry dose measurements and Monte Carlo dose calculations for verification and validation of individual patient treatments. Respiratory-gated IMRT is accepted by both treatment staff and patients. The dosimetric and positional quality assurance test results indicate that respiratory-gated IMRT can be delivered accurately. If carefully implemented, respiratory-gated IMRT is a practical alternative to conventional thoracic radiotherapy. For mobile tumors, respiratory-gated radiotherapy is used as the standard of care at our institution. Due to the increased workload, the choice of IMRT is taken on a case-by-case basis, with approximately half of the non-small cell lung cancer patients receiving respiratory-gated IMRT. We are currently evaluating whether superior tumor coverage and limited normal tissue dosing will lead to improvements in local control and survival in non-small cell lung cancer

Profile of respiratory problems in patients presenting to a referral pulmonary clinic

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Dasgupta Angira

2008-01-01

Full Text Available Analysis of OPD data of 2012 patients in a referral pulmonary clinic at Kolkata was done following a protocol-based approach. Obstructive airway diseases (COPD and asthma were the most common (43% problem followed by infective lung diseases (15% including tuberculosis, bronchogenic carcinoma (8%, ILD (4%, haemopty-sis of undiagnosed etiology (4.5%, chronic cough of undiagnosed etiology (6.5% and pleural diseases (4.6%. Other diseases like obstructive sleep apnoea, sarcoid-osis, systemic diseases with lung involvements etc., and non respiratory problems formed the rest (14.4%.

Respiratory Constraints in Verbal and Non-verbal Communication.

Science.gov (United States)

Włodarczak, Marcin; Heldner, Mattias

2017-01-01

In the present paper we address the old question of respiratory planning in speech production. We recast the problem in terms of speakers' communicative goals and propose that speakers try to minimize respiratory effort in line with the H&H theory. We analyze respiratory cycles coinciding with no speech (i.e., silence), short verbal feedback expressions (SFE's) as well as longer vocalizations in terms of parameters of the respiratory cycle and find little evidence for respiratory planning in feedback production. We also investigate timing of speech and SFEs in the exhalation and contrast it with nods. We find that while speech is strongly tied to the exhalation onset, SFEs are distributed much more uniformly throughout the exhalation and are often produced on residual air. Given that nods, which do not have any respiratory constraints, tend to be more frequent toward the end of an exhalation, we propose a mechanism whereby respiratory patterns are determined by the trade-off between speakers' communicative goals and respiratory constraints.

Dysrhythmias of the respiratory oscillator

Science.gov (United States)

Paydarfar, David; Buerkel, Daniel M.

1995-03-01

Breathing is regulated by a central neural oscillator that produces rhythmic output to the respiratory muscles. Pathological disturbances in rhythm (dysrhythmias) are observed in the breathing pattern of children and adults with neurological and cardiopulmonary diseases. The mechanisms responsible for genesis of respiratory dysrhythmias are poorly understood. The present studies take a novel approach to this problem. The basic postulate is that the rhythm of the respiratory oscillator can be altered by a variety of stimuli. When the oscillator recovers its rhythm after such perturbations, its phase may be reset relative to the original rhythm. The amount of phase resetting is dependent upon stimulus parameters and the level of respiratory drive. The long-range hypothesis is that respiratory dysrhythmias can be induced by stimuli that impinge upon or arise within the respiratory oscillator with certain combinations of strength and timing relative to the respiratory cycle. Animal studies were performed in anesthetized or decerebrate preparations. Neural respiratory rhythmicity is represented by phrenic nerve activity, allowing use of open-loop experimental conditions which avoid negative chemical feedback associated with changes in ventilation. In animal experiments, respiratory dysrhythmias can be induced by stimuli having specific combinations of strength and timing. Newborn animals readily exhibit spontaneous dysrhythmias which become more prominent at lower respiratory drives. In human subjects, swallowing was studied as a physiological perturbation of respiratory rhythm, causing a pattern of phase resetting that is characterized topologically as type 0. Computational studies of the Bonhoeffer-van der Pol (BvP) equations, whose qualitative behavior is representative of many excitable systems, supports a unified interpretation of these experimental findings. Rhythmicity is observed when the BvP model exhibits recurrent periods of excitation alternating with

Respiratory analysis system and method

Science.gov (United States)

Liu, F. F. (Inventor)

1973-01-01

A system is described for monitoring the respiratory process in which the gas flow rate and the frequency of respiration and expiration cycles can be determined on a real time basis. A face mask is provided with one-way inlet and outlet valves where the gas flow is through independent flowmeters and through a mass spectrometer. The opening and closing of a valve operates an electrical switch, and the combination of the two switches produces a low frequency electrical signal of the respiratory inhalation and exhalation cycles. During the time a switch is operated, the corresponsing flowmeter produces electric pulses representative of the flow rate; the electrical pulses being at a higher frequency than that of the breathing cycle and combined with the low frequency signal. The high frequency pulses are supplied to conventional analyzer computer which also receives temperature and pressure inputs and computes mass flow rate and totalized mass flow of gas. From the mass spectrometer, components of the gas are separately computed as to flow rate. The electrical switches cause operation of up-down inputs of a reversible counter. The respective up and down cycles can be individually monitored and combined for various respiratory measurements.

Respiratory inflammation and infections in high-performance athletes.

Science.gov (United States)

Gleeson, Maree; Pyne, David B

2016-02-01

Upper respiratory illness is the most common reason for non-injury-related presentation to a sports medicine clinic, accounting for 35-65% of illness presentations. Recurrent or persistent respiratory illness can have a negative impact on health and performance of athletes undertaking high levels of strenuous exercise. The cause of upper respiratory symptoms (URS) in athletes can be uncertain but the majority of cases are related to common respiratory viruses, viral reactivation, allergic responses to aeroallergens and exercise-related trauma to the integrity of respiratory epithelial membranes. Bacterial respiratory infections are uncommon in athletes. Undiagnosed or inappropriately treated asthma and/or allergy are common findings in clinical assessments of elite athletes experiencing recurrent URS. High-performance athletes with recurrent episodes of URS should undergo a thorough clinical assessment to exclude underlying treatable conditions of respiratory inflammation. Identifying athletes at risk of recurrent URS is important in order to prescribe preventative clinical, training and lifestyle strategies. Monitoring secretion rates and falling concentrations of salivary IgA can identify athletes at risk of URS. Therapeutic interventions are limited by the uncertainty of the underlying cause of inflammation. Topical anti-inflammatory sprays can be beneficial for some athletes. Dietary supplementation with bovine colostrum, probiotics and selected antioxidants can reduce the incidence or severity of URS in some athletes. Preliminary studies on athletes prone to URS indicate a genetic predisposition to a pro-inflammatory response and a dysregulated anti-inflammatory cytokine response to intense exercise as a possible mechanism of respiratory inflammation. This review focuses on respiratory infections and inflammation in elite/professional athletes.

[Respiratory treatments in neuromuscular disease].

Science.gov (United States)

Martínez Carrasco, C; Cols Roig, M; Salcedo Posadas, A; Sardon Prado, O; Asensio de la Cruz, O; Torrent Vernetta, A

2014-10-01

In a previous article, a review was presented of the respiratory pathophysiology of the patient with neuromuscular disease, as well as their clinical evaluation and the major complications causing pulmonary deterioration. This article presents the respiratory treatments required to preserve lung function in neuromuscular disease as long as possible, as well as in special situations (respiratory infections, spinal curvature surgery, etc.). Special emphasis is made on the use of non-invasive ventilation, which is changing the natural history of many of these diseases. The increase in survival and life expectancy of these children means that they can continue their clinical care in adult units. The transition from pediatric care must be an active, timely and progressive process. It may be slightly stressful for the patient before the adaptation to this new environment, with multidisciplinary care always being maintained. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

Influenza and other respiratory viruses: standardizing disease severity in surveillance and clinical trials.

Science.gov (United States)

Rath, Barbara; Conrad, Tim; Myles, Puja; Alchikh, Maren; Ma, Xiaolin; Hoppe, Christian; Tief, Franziska; Chen, Xi; Obermeier, Patrick; Kisler, Bron; Schweiger, Brunhilde

2017-06-01

Influenza-Like Illness is a leading cause of hospitalization in children. Disease burden due to influenza and other respiratory viral infections is reported on a population level, but clinical scores measuring individual changes in disease severity are urgently needed. Areas covered: We present a composite clinical score allowing individual patient data analyses of disease severity based on systematic literature review and WHO-criteria for uncomplicated and complicated disease. The 22-item ViVI Disease Severity Score showed a normal distribution in a pediatric cohort of 6073 children aged 0-18 years (mean age 3.13; S.D. 3.89; range: 0 to 18.79). Expert commentary: The ViVI Score was correlated with risk of antibiotic use as well as need for hospitalization and intensive care. The ViVI Score was used to track children with influenza, respiratory syncytial virus, human metapneumovirus, human rhinovirus, and adenovirus infections and is fully compliant with regulatory data standards. The ViVI Disease Severity Score mobile application allows physicians to measure disease severity at the point-of care thereby taking clinical trials to the next level.

Respiratory

Science.gov (United States)

The words "respiratory" and "respiration" refer to the lungs and breathing. ... Boron WF. Organization of the respiratory system. In: Boron WF, Boulpaep EL, eds. Medical Physiology . 3rd ed. Philadelphia, PA: Elsevier; 2017:chap 26.

Spontaneous group synchronization of movements and respiratory rhythms.

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Erwan Codrons

Full Text Available We tested whether pre-assigned arm movements performed in a group setting spontaneously synchronized and whether synchronization extended to heart and respiratory rhythms. We monitored arm movements, respiration and electrocardiogram at rest and during spontaneous, music and metronome-associated arm-swinging. No directions were given on whether or how the arm swinging were to be synchronized between participants or with the external cues. Synchronization within 3 groups of 10 participants studied collectively was compared with pseudo-synchronization of 3 groups of 10 participants that underwent an identical protocol but in an individual setting. Motor synchronization was found to be higher in the collective groups than in the individuals for the metronome-associated condition. On a repetition of the protocol on the following day, motor synchronization in the collective groups extended to the spontaneous, un-cued condition. Breathing was also more synchronized in the collective groups than in the individuals, particularly at rest and in the music-associated condition. Group synchronization occurs without explicit instructions, and involves both movements and respiratory control rhythms.

The respiratory microbiome and respiratory infections

NARCIS (Netherlands)

Unger, Stefan A.; Bogaert, Debby

2017-01-01

Despite advances over the past ten years lower respiratory tract infections still comprise around a fifth of all deaths worldwide in children under five years of age with the majority in low- and middle-income countries. Known risk factors for severe respiratory infections and poor chronic

Is recurrent respiratory infection associated with allergic respiratory disease?

Science.gov (United States)

de Oliveira, Tiago Bittencourt; Klering, Everton Andrei; da Veiga, Ana Beatriz Gorini

2018-03-13

Respiratory infections cause high morbidity and mortality worldwide. This study aims to estimate the relationship between allergic respiratory diseases with the occurrence of recurrent respiratory infection (RRI) in children and adolescents. The International Study of Asthma and Allergies in Childhood questionnaire and a questionnaire that provides data on the history of respiratory infections and the use of antibiotics were used to obtain data from patients. The relationship between the presence of asthma or allergic rhinitis and the occurrence of respiratory infections in childhood was analyzed. We interviewed the caregivers of 531 children aged 0 to 15 years. The average age of participants was 7.43 years, with females accounting for 52.2%. This study found significant relationship between: presence of asthma or allergic rhinitis with RRI, with prevalence ratio (PR) of 2.47 (1.51-4.02) and 1.61 (1.34-1.93), respectively; respiratory allergies with use of antibiotics for respiratory problems, with PR of 5.32 (2.17-13.0) for asthma and of 1.64 (1.29-2.09) for allergic rhinitis; asthma and allergic rhinitis with diseases of the lower respiratory airways, with PR of 7.82 (4.63-13.21) and 1.65 (1.38-1.96), respectively. In contrast, no relationship between upper respiratory airway diseases and asthma and allergic rhinitis was observed, with PR of 0.71 (0.35-1.48) and 1.30 (0.87-1.95), respectively. RRI is associated with previous atopic diseases, and these conditions should be considered when treating children.

Climate change and respiratory health.

Science.gov (United States)

Gerardi, Daniel A; Kellerman, Roy A

2014-10-01

To discuss the nature of climate change and both its immediate and long-term effects on human respiratory health. This review is based on information from a presentation of the American College of Chest Physicians course on Occupational and Environmental Lung Disease held in Toronto, Canada, June 2013. It is supplemented by a PubMed search for climate change, global warming, respiratory tract diseases, and respiratory health. It is also supplemented by a search of Web sites including the Environmental Protection Agency, National Oceanic and Atmospheric Administration, World Meteorological Association, National Snow and Ice Data Center, Carbon Dioxide Information Analysis Center, Inter-Governmental Panel on Climate Change, and the World Health Organization. Health effects of climate change include an increase in the prevalence of certain respiratory diseases, exacerbations of chronic lung disease, premature mortality, allergic responses, and declines in lung function. Climate change, mediated by greenhouse gases, causes adverse health effects to the most vulnerable patient populations-the elderly, children, and those in distressed socioeconomic strata.

Congenital nasal pyriform aperture stenosis as a cause of respiratory distress in newborns: presentation diagnosed by menas of CT

International Nuclear Information System (INIS)

Wichoff, A.; Perez-Candela, V.; Romera, C.; Lopez-Morales, L.

2002-01-01

Congenital nasal pyriform aperture stenosis (CNPAS) is a rare cause of newborn airway obstruction. It can be clinically indistinguishable from choanal atresia, which is much more frequent. CT confirms the diagnosis by revealing in detail the anatomical alterations underlying this anomaly. These might or might not occur in association with other alterations. We present 4 cases of CNPAS, all of which presented respiratory distress and clinical symptoms similar to those of choanal atresia in newborn children. The premature diagnosis and a conventional treatment of tube placement in order to keep the airway open, until the pyriform aperture grows large enough to permit normal breathing, resulted in recovery of the patients. (Author) 12 refs

Longitudinal study of respiratory function and symptoms in a non-smoking group of long-term officially-acknowledged victims of pollution-related illness

OpenAIRE

Tanaka, Takako; Asai, Masaharu; Yanagita, Yorihide; Nishinakagawa, Tsuyoshi; Miyamoto, Naomi; Kotaki, Kenji; Yano, Yudai; Kozu, Ryo; Honda, Sumihisa; Senjyu, Hideaki

2013-01-01

Background Air pollution is known to be a leading cause of respiratory symptoms. Many cross-sectional studies reported that air pollution caused respiratory disease in Japanese individuals in the 1960s. Japan has laws regulating air pollution levels and providing compensation for victims of pollution-related respiratory disease. However, long-term changes in respiratory function and symptoms in individuals who were exposed to air pollution in the 1960s have not been well studied. This study a...

Seasonal variations of respiratory viruses detected from children with respiratory tract infections in Riyadh, Saudi Arabia

Directory of Open Access Journals (Sweden)

Saad S. Albogami

2018-03-01

Full Text Available ARTIs have a huge impact in health systems in which 20–30% of all hospital admissions and 30–60% of practitioner visits are related to respiratory tract infections. The aim of this study is to determine the prevalence, age distribution, and seasonal variation of respiratory viruses. This study was descriptive retrospective study in which all patients 14 years of age and below who presented with signs and symptoms of ARTIs between January 2013 and December 2014 and had respiratory specimen tested by direct immunofluorescence assays for viruses identification were included in the study. During that period, a total of 4611 patients who presented with ARTIs from January 2013 to December 2014 were investigated, viruses were detected in 1115 (24%. RSV was associated with 97.4% of the total viral pathogens. Viruses were detected throughout all the two years with a peak in winter; Dec (n: 265, Jan (n: 418, Feb (n: 218, and Mar (n: 109. Viral pathogens are very important cause of ARTIs in our region. RSV was the most common virus detected with the highest detection rate in children who are two years old and below. A multi-center surveillance with more sensitive detection methods like PCR may help to provide a comprehensive understanding of virus distribution in our area, which may contribute implant an effective prevention approach for each virus. Keywords: Pediatrics, Infectious diseases, Respiratory infections, Respiratory syncytial virus, Saudi Arabia

Porcine Reproductive and Respiratory Syndrome Virus (PRRSV)

DEFF Research Database (Denmark)

Kvisgaard, Lise Kirstine

This PhD thesis presents the diversity of Porcine Reproductive and Respiratory Syndrome viruses (PRRSV) circulating in the Danish pig population. PRRS is a disease in pigs caused by the PRRS virus resulting in reproductive failures in sows and gilts and respiratory diseases in pigs . Due to genetic...

Respiratory Constraints in Verbal and Non-verbal Communication

Directory of Open Access Journals (Sweden)

Marcin Włodarczak

2017-05-01

Full Text Available In the present paper we address the old question of respiratory planning in speech production. We recast the problem in terms of speakers' communicative goals and propose that speakers try to minimize respiratory effort in line with the H&H theory. We analyze respiratory cycles coinciding with no speech (i.e., silence, short verbal feedback expressions (SFE's as well as longer vocalizations in terms of parameters of the respiratory cycle and find little evidence for respiratory planning in feedback production. We also investigate timing of speech and SFEs in the exhalation and contrast it with nods. We find that while speech is strongly tied to the exhalation onset, SFEs are distributed much more uniformly throughout the exhalation and are often produced on residual air. Given that nods, which do not have any respiratory constraints, tend to be more frequent toward the end of an exhalation, we propose a mechanism whereby respiratory patterns are determined by the trade-off between speakers' communicative goals and respiratory constraints.

Short-term respiratory effects of cleaning exposures in female domestic cleaners.

Science.gov (United States)

Medina-Ramón, M; Zock, J P; Kogevinas, M; Sunyer, J; Basagaña, X; Schwartz, J; Burge, P S; Moore, V; Antó, J M

2006-06-01

Symptoms of obstructive lung disease in domestic cleaners have been related to the use of bleach and other irritant cleaning products. The short-term effects of cleaning exposures on respiratory symptoms and peak expiratory flow (PEF) were investigated in domestic cleaners with respiratory disorders. In a panel study, 43 female domestic cleaners with a recent history of asthma and/or chronic bronchitis completed a 2-week diary, collecting information on respiratory symptoms, PEF and cleaning exposures. Mixed regression models were used to assess daily changes in symptoms and PEF associated with specific cleaning exposures. The probability of having work-related asthma was individually assessed by a computerised diagnostic system and an occupational asthma expert. Lower respiratory tract symptoms were more common on working days and were predominantly associated with exposure to diluted bleach, degreasing sprays/atomisers and air fresheners. Associations with upper respiratory tract symptoms and PEF were less apparent. Eleven (30%) subjects scored positively for work-related asthma. It is concluded that exposure to certain irritant cleaning products aggravates lower respiratory tract symptoms in female domestic cleaners with asthma or chronic bronchitis.

Predictors for return to work for those with occupational respiratory disease: clinical and structural factors.

Science.gov (United States)

Zoeckler, Jeanette M; Cibula, Donald A; Morley, Christopher P; Lax, Michael B

2013-12-01

Few occupational researchers have examined "return to work" among patients with work-related respiratory diseases. In addition, prior studies have emphasized individual patient characteristics rather than a more multi-dimensional approach that includes both clinical and structural factors. A retrospective chart review identified patients with occupational respiratory diseases in the Occupational Health Clinical Center, Syracuse, NY between 1991 and 2009. We assessed predictors of work status using an exploratory, sequential mixed methods research design, multinomial (n = 188) and Cox regressions (n = 130). The findings suggest that patients with an increased number of diagnoses, non-union members, and those who took more than a year before clinical presentation had significantly poorer work status outcomes, after adjusting for age, education level, and relevant diagnoses. Efforts to prevent slow return to work after developing occupational respiratory disease should recognize the importance of timely access to occupational health services, disease severity, union membership, and smoking status. © 2013 Wiley Periodicals, Inc.

Respiratory correlated cone beam CT

International Nuclear Information System (INIS)

Sonke, Jan-Jakob; Zijp, Lambert; Remeijer, Peter; Herk, Marcel van

2005-01-01

A cone beam computed tomography (CBCT) scanner integrated with a linear accelerator is a powerful tool for image guided radiotherapy. Respiratory motion, however, induces artifacts in CBCT, while the respiratory correlated procedures, developed to reduce motion artifacts in axial and helical CT are not suitable for such CBCT scanners. We have developed an alternative respiratory correlated procedure for CBCT and evaluated its performance. This respiratory correlated CBCT procedure consists of retrospective sorting in projection space, yielding subsets of projections that each corresponds to a certain breathing phase. Subsequently, these subsets are reconstructed into a four-dimensional (4D) CBCT dataset. The breathing signal, required for respiratory correlation, was directly extracted from the 2D projection data, removing the need for an additional respiratory monitor system. Due to the reduced number of projections per phase, the contrast-to-noise ratio in a 4D scan reduced by a factor 2.6-3.7 compared to a 3D scan based on all projections. Projection data of a spherical phantom moving with a 3 and 5 s period with and without simulated breathing irregularities were acquired and reconstructed into 3D and 4D CBCT datasets. The positional deviations of the phantoms center of gravity between 4D CBCT and fluoroscopy were small: 0.13±0.09 mm for the regular motion and 0.39±0.24 mm for the irregular motion. Motion artifacts, clearly present in the 3D CBCT datasets, were substantially reduced in the 4D datasets, even in the presence of breathing irregularities, such that the shape of the moving structures could be identified more accurately. Moreover, the 4D CBCT dataset provided information on the 3D trajectory of the moving structures, absent in the 3D data. Considerable breathing irregularities, however, substantially reduces the image quality. Data presented for three different lung cancer patients were in line with the results obtained from the phantom study. In

Partnering for optimal respiratory home care: physicians working with respiratory therapists to optimally meet respiratory home care needs.

Science.gov (United States)

Spratt, G; Petty, T L

2001-05-01

The need for respiratory care services continues to increase, reimbursement for those services has decreased, and cost-containment measures have increased the frequency of home health care. Respiratory therapists are well qualified to provide home respiratory care, reduce misallocation of respiratory services, assess patient respiratory status, identify problems and needs, evaluate the effect of the home setting, educate the patient on proper equipment use, monitor patient response to and complications of therapy, monitor equipment functioning, monitor for appropriate infection control procedures, make recommendations for changes to therapy regimen, and adjust therapy under the direction of the physician. Teamwork benefits all parties and offers cost and time savings, improved data collection and communication, higher job satisfaction, and better patient monitoring, education, and quality of life. Respiratory therapists are positioned to optimize treatment efficacy, maximize patient compliance, and minimize hospitalizations among patients receiving respiratory home care.

Hypoxemic Respiratory Failure from Acute Respiratory Distress Syndrome Secondary to Leptospirosis

Directory of Open Access Journals (Sweden)

Shannon M. Fernando

2017-01-01

Full Text Available Acute respiratory distress syndrome (ARDS, characterized by hypoxemic respiratory failure, is associated with a mortality of 30–50% and is precipitated by both direct and indirect pulmonary insults. Treatment is largely supportive, consisting of lung protective ventilation and thereby necessitating Intensive Care Unit (ICU admission. The most common precipitant is community-acquired bacterial pneumonia, but other putative pathogens include viruses and fungi. On rare occasions, ARDS can be secondary to tropical disease. Accordingly, a history should include travel to endemic regions. Leptospirosis is a zoonotic disease most common in the tropics and typically associated with mild pulmonary complications. We describe a case of a 25-year-old male with undiagnosed leptospirosis, presenting with fever and severe hypoxemic respiratory failure, returning from a Costa Rican holiday. There was no other organ failure. He was intubated and received lung protective ventilation. His condition improved after ampicillin and penicillin G were added empirically. This case illustrates the rare complication of ARDS from leptospirosis, the importance of taking a travel history, and the need for empiric therapy because of diagnostic delay.

Sulpyrine inhalation challenge test monitored continuously by respiratory impedance and 81mKr ventilation image

International Nuclear Information System (INIS)

Suenaga, Naoto; Nakamura, Hitoshi; Shiratsuki, Natsuo; Nishioka, Yasuhiro; Kitada, Osamu; Sugita, Minoru

1993-01-01

Continuous changes of respiratory impedance by the oscillation method using Asthograph and 81m Kr ventilation image during saline and sulpyrine solution (100 mg/ml, 250 mg/ml) provocation were simultaneously measured in 15 adult asthmatics and 7 normal individuals. Estimation of airway obstruction by respiratory impedance using Asthograph was difficult during sulpyrine inhalation, since respiratory impedance increased gradually. In addition to the measurement of respiratory impedance, images of 81m Kr ventilation were also obtained to estimate the regional ventilatory distribution. Estimation of the airway obstruction was easily obtained. Another advantage of 81m Kr ventilation image is that it can estimate the regional ventilatory distribution. The site of airway obstruction provoked by sulpyrine was observed predominantly in the lower lung field. The results of our present study were as follows. In 3 patients, increase of respiratory impedance and defect of 81m Kr ventilation image were observed. Two cases in this group were clinically diagnosed as having aspirin-induced asthma. In 7 patients, a defect of 81m Kr ventilation image was observed, but no increase of respiratory impedance was observed. Five cases in this group could not be clinically diagnosed as having aspirin-induced asthma. In 5 patients, neither defect of 81m Kr ventilation image nor increase of respiratory impedance could be detected. These results suggest that 81m Kr ventilation image on sulpyrine inhalation challenge test is a useful method for evaluating regional ventilatory distribution, but should be further investigated for application to aspirin-induced asthma. (author)

Respiratory care manpower issues.

Science.gov (United States)

Mathews, Paul; Drumheller, Lois; Carlow, John J

2006-03-01

Although respiratory care is a relatively new profession, its practitioners are deeply involved in providing patient care in the critical care. In preparation for writing this article, we sought to explore the respiratory therapy manpower needs and activities designed to fulfill those needs in critical care practice. We began by delineating the historical development of respiratory care as a profession, the development of its education, and the professional credentialing system. We then conducted several literature reviews with few articles generated. We requested and received data from the American Association for Respiratory Care (AARC), The National Board for Respiratory Care (NBRC), and the Committee on Accreditation of Respiratory Care education (CoARC) relative to their membership, number of credentialed individuals, and educational program student and graduate data for 2000 through 2004. We then conducted two electronic surveys. Survey 1 was a six-item survey that examined the use of mandatory overtime in respiratory care departments. We used a convenience sample of 30 hospitals stratified by size (or=500 beds). Survey 2 was a five-item instrument distributed by blast E-mail to the Society of Critical Care Medicine's Respiratory Care Section members and members of the RC_World list serve. This survey elicited 51 usable and non-duplicative responses from geographically and size-varied institutions. We analyzed these data in several ways from distribution analysis to one-way analysis of variance procedure and appropriate post hoc analysis techniques. Where appropriate, a matched-pairs analysis was performed and these were compared across the variables intensive care unit (ICU) beds per actual number of respiratory care practitioners (RCPs) and ICU beds per preferred number of RCPs. The data gathered from the professional organizations indicated a relatively stable attrition rate (35.2%+/-1.7-3.1%), even in the face of varying enrollments (6,231 in 2004 vs. 4

Human Respiratory Syncytial Virus and Human Metapneumovirus

Directory of Open Access Journals (Sweden)

Luciana Helena Antoniassi da Silva

2009-08-01

Full Text Available The human respiratory syncytial virus (hRSV and the human metapneumovírus (hMPV are main etiological agents of acute respiratory infections (ARI. The ARI is an important cause of childhood morbidity and mortality worldwide.  hRSV and hMPV are members of the Paramyxoviridae. They are enveloped, non-segmented viruses, with negative-sense single stranded genomes. Respiratory syncytial virus (hRSV is the best characterized agent viral of this group, associated with respiratory diseases in lower respiratory tract. Recently, a new human pathogen belonging to the subfamily Pneumovirinae was identified, the human metapneumovirus (hMPV, which is structurally similar to the hRSV, in genomic organization, viral structure, antigenicity and clinical symptoms.  The subfamily Pneumovirinae contains two genera: genus Pneumovirus contains hRSV, the bovine (bRSV, as well as the ovine and caprine respiratory syncytial virus and pneumonia virus of mice, the second genus Metapneumovirus, consists of avian metapneumovirus (aMPV and human metapneumovirus (hMPV. In this work, we present a brief narrative review of the literature on important aspects of the biology, epidemiology and clinical manifestations of infections by two respiratory viruses.

Upper Respiratory Tract Diseases in Athletes in Different Sports Disciplines.

Science.gov (United States)

Gałązka-Franta, Anna; Jura-Szołtys, Edyta; Smółka, Wojciech; Gawlik, Radosław

2016-12-01

Upper respiratory tract diseases in athletes are a very common medical problem. Training conditions in different sports disciplines increase the risk of upper respiratory disease. Epidemiological evidence suggests that heavy acute or chronic exercise is related to an increased incidence of upper respiratory tract infections in athletes. Regular physical exercise at high intensity may lead to transient immunosuppression due to high prevalence of allergic diseases in athletes. Regardless of the cause they can exclude athletes from the training program and significantly impair their performance. In the present work, the most common upper respiratory tract diseases in athletes taking into account the disciplines in which they most often occur were presented. The focus was laid on symptoms, diagnostic methods and pharmacotherapy. Moreover, preventive procedures which can help reduce the occurrence of upper respiratory tract disease in athletes were presented. Management according to anti-doping rules, criteria for return to training and competition as an important issues of athlete's health were discussed.

The respiratory practical persons: new understanding and approaches.

Directory of Open Access Journals (Sweden)

Ruslanov D.V.

2011-02-01

Full Text Available It is analysed modern information about existent respiratory practices. The methodological, physiological and psychological aspects of respiratory practices are examined. 2 groups of students of higher humanitarian institute are participated in experiment: healthy (students of basic group, n1=180 and with different chronic pathology in the stage of remission (students of group of medical physical education, n2=50. Duration of experiment made about two months. Frequency of the controlled respiratory practice - 1-2 times per a week. The algorithm of respiratory practice is presented. Exercises and recommendations are resulted on their application.

Respiratory Diseases in Children: studies in general practice

NARCIS (Netherlands)

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

2011-01-01

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

Climate Change and Respiratory Infections.

Science.gov (United States)

Mirsaeidi, Mehdi; Motahari, Hooman; Taghizadeh Khamesi, Mojdeh; Sharifi, Arash; Campos, Michael; Schraufnagel, Dean E

2016-08-01

The rate of global warming has accelerated over the past 50 years. Increasing surface temperature is melting glaciers and raising the sea level. More flooding, droughts, hurricanes, and heat waves are being reported. Accelerated changes in climate are already affecting human health, in part by altering the epidemiology of climate-sensitive pathogens. In particular, climate change may alter the incidence and severity of respiratory infections by affecting vectors and host immune responses. Certain respiratory infections, such as avian influenza and coccidioidomycosis, are occurring in locations previously unaffected, apparently because of global warming. Young children and older adults appear to be particularly vulnerable to rapid fluctuations in ambient temperature. For example, an increase in the incidence in childhood pneumonia in Australia has been associated with sharp temperature drops from one day to the next. Extreme weather events, such as heat waves, floods, major storms, drought, and wildfires, are also believed to change the incidence of respiratory infections. An outbreak of aspergillosis among Japanese survivors of the 2011 tsunami is one such well-documented example. Changes in temperature, precipitation, relative humidity, and air pollution influence viral activity and transmission. For example, in early 2000, an outbreak of Hantavirus respiratory disease was linked to a local increase in the rodent population, which in turn was attributed to a two- to threefold increase in rainfall before the outbreak. Climate-sensitive respiratory pathogens present challenges to respiratory health that may be far greater in the foreseeable future.

An official American thoracic society/European respiratory society statement: Key concepts and advances in pulmonary rehabilitation

NARCIS (Netherlands)

M.A. Spruit (Martijn); S.J. Singh (Sally); C. Garvey (Chris); R. Zu Wallack (Richard); L. Nici (Linda); C. Rochester (Carolyn); K. Hill (Kylie); A.E. Holland (Anne); S.C. Lareau (Suzanne); W.D.-C. Man (William); F. Pitta (Fabio); L. Sewell (Louise); J. Raskin (Jonathan); J. Bourbeau (Jean); R. Crouch (Rebecca); F.M.E. Franssen (Frits); R. Casaburi (Richard); J.H. Vercoulen (Jan); I. Vogiatzis (Ioannis); R.A.A.M. Gosselink (Rik); E.M. Clini (Enrico); T.W. Effing (Tanja); F. Maltais (François); J. van der Palen (Job); T. Troosters; D.J.A. Janssen (Daisy); E. Collins (Eileen); J. Garcia-Aymerich (Judith); D. Brooks (Dina); B.F. Fahy (Bonnie); M.A. Puhan (Milo); M. Hoogendoorn (Martine); R. Garrod (Rachel); A.M.W.J. Schols (Annemie); B. Carlin (Brian); R. Benzo (Roberto); P. Meek (Paula); M. Morgan (Mike); M.P.M.H. Rutten-van Mölken (Maureen); A.L. Ries (Andrew); B. Make (Barry); R.S. Goldstein (Roger); C.A. Dowson (Claire); J.L. Brozek (Jan); C.F. Donner (Claudio); E.F.M. Wouters (Emiel)

2013-01-01

textabstractBackground: Pulmonary rehabilitation is recognized as a core component of themanagement of individuals with chronic respiratory disease. Since the 2006 American Thoracic Society (ATS)/European Respiratory Society (ERS) Statement on Pulmonary Rehabilitation, there has been considerable

Resting respiratory sinus arrhythmia is associated with tonic positive emotionality.

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Oveis, Christopher; Cohen, Adam B; Gruber, June; Shiota, Michelle N; Haidt, Jonathan; Keltner, Dacher

2009-04-01

Resting respiratory sinus arrhythmia (RSAREST) indexes important aspects of individual differences in emotionality. In the present investigation, the authors address whether RSAREST is associated with tonic positive or negative emotionality, and whether RSAREST relates to phasic emotional responding to discrete positive emotion-eliciting stimuli. Across an 8-month, multiassessment study of first-year university students (n = 80), individual differences in RSAREST were associated with positive but not negative tonic emotionality, assessed at the level of personality traits, long-term moods, the disposition toward optimism, and baseline reports of current emotional states. RSAREST was not related to increased positive emotion, or stimulus-specific emotion, in response to compassion-, awe-, or pride-inducing stimuli. These findings suggest that resting RSA indexes aspects of a person's tonic positive emotionality. (c) 2009 APA, all rights reserved.

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

DEFF Research Database (Denmark)

Illes, Zsolt; Mike, Andrea; Trauninger, Anita

2014-01-01

Introduction: The relationship between skeletal muscle strength and respiratory dysfunction in Pompe disease has not been examined by quantitative methods. We investigated correlations among lower extremity proximal muscle strength, respiratory function, and motor performance. Methods: Concentric...... strength of the knee extensor and flexor muscles were measured with a dynamometer, and pulmonary function was evaluated using spirometry in 7 adult patients. The six-minute walk test and the four-step stair-climb test were used for assessing aerobic endurance and anaerobic power, respectively. Results......: Anaerobic motor performance correlated with strength of both thigh muscles. Respiratory function did not correlate with either muscle strength or motor function performance. Conclusions: Respiratory and lower extremity proximal muscles could be differentially affected by the disease in individual patients...

Housing and respiratory health at older ages.

Science.gov (United States)

Webb, E; Blane, D; de Vries, Robert

2013-03-01

A large proportion of the population of England live in substandard housing. Previous research has suggested that poor-quality housing, particularly in terms of cold temperatures, mould, and damp, poses a health risk, particularly for older people. The present study aimed to examine the association between housing conditions and objectively measured respiratory health in a large general population sample of older people in England. Data on housing conditions, respiratory health and relevant covariates were obtained from the second wave of the English Longitudinal Study of Ageing. Multivariate regression methods were used to test the association between contemporary housing conditions and respiratory health while accounting for the potential effect of other factors; including social class, previous life-course housing conditions and childhood respiratory health. Older people who were in fuel poverty or who did not live in a home they owned had significantly worse respiratory health as measured by peak expiratory flow rates. After accounting for covariates, these factors had no effect on any other measures of respiratory health. Self-reported housing problems were not consistently associated with respiratory health. The housing conditions of older people in England, particularly those associated with fuel poverty and living in rented accommodation, may be harmful to some aspects of respiratory health. This has implications for upcoming UK government housing and energy policy decisions.

Propagation of respiratory aerosols by the vuvuzela.

Directory of Open Access Journals (Sweden)

Ka-Man Lai

Full Text Available Vuvuzelas, the plastic blowing horns used by sports fans, recently achieved international recognition during the FIFA World Cup soccer tournament in South Africa. We hypothesised that vuvuzelas might facilitate the generation and dissemination of respiratory aerosols. To investigate the quantity and size of aerosols emitted when the instrument is played, eight healthy volunteers were asked to blow a vuvuzela. For each individual the concentration of particles in expelled air was measured using a six channel laser particle counter and the duration of blowing and velocity of air leaving the vuvuzela were recorded. To allow comparison with other activities undertaken at sports events each individual was also asked to shout and the measurements were repeated while using a paper cone to confine the exhaled air. Triplicate measurements were taken for each individual. The mean peak particle counts were 658 × 10(3 per litre for the vuvuzela and 3.7 × 10(3 per litre for shouting, representing a mean log(10 difference of 2.20 (95% CI: 2.03,2.36; p 97% of particles captured from either the vuvuzela or shouting were between 0.5 and 5 microns in diameter. Mean peak airflows recorded for the vuvuzela and shouting were 6.1 and 1.8 litres per second respectively. We conclude that plastic blowing horns (vuvuzelas have the capacity to propel extremely large numbers of aerosols into the atmosphere of a size able to penetrate the lower lung. Some respiratory pathogens are spread via contaminated aerosols emitted by infected persons. Further investigation is required to assess the potential of the vuvuzela to contribute to the transmission of aerosol borne diseases. We recommend, as a precautionary measure, that people with respiratory infections should be advised not to blow their vuvuzela in enclosed spaces and where there is a risk of infecting others.

Prolonged lateral steep position impairs respiratory mechanics during continuous lateral rotation therapy in respiratory failure.

Science.gov (United States)

Schellongowski, Peter; Losert, Heidrun; Locker, Gottfried J; Laczika, Klaus; Frass, Michael; Holzinger, Ulrike; Bojic, Andja; Staudinger, Thomas

2007-04-01

To establish whether prolonged lateral steep position during continuous rotation therapy leads to improvement on pulmonary gas exchange, respiratory mechanics and hemodynamics. Prospective observational study. Intensive care unit of a university hospital. Twelve consecutive patients suffering from acute lung injury or adult respiratory distress syndrome undergoing continuous rotation therapy. Blood gas analysis, static lung compliance, blood pressure, cardiac index and pulmonary shunt fraction were measured in supine as well as in left and right lateral steep position at 62 degrees during continuous rotation therapy (phase I). Rotation was then stopped for 30 min with the patients in supine position, left and right lateral steep position, and the same measurements were performed every 10 min (phase II). Phase I and II revealed no significant changes in PaO(2)/FiO(2) ratio, mean arterial blood pressure, pulmonary shunt fraction, or cardiac index. Significantly lower static compliance was observed in lateral steep position than in supine position (pposition than in left and right lateral steep position (ppositioning impairs the compliance of the respiratory system. Prolonged lateral steep position does not lead to benefits with respect to oxygenation or hemodynamics. Individual response to the different positions is unpredictable. The pauses in "extreme" positions should be as short as possible.

Increased respiratory neural drive and work of breathing in exercise-induced laryngeal obstruction.

Science.gov (United States)

Walsted, Emil S; Faisal, Azmy; Jolley, Caroline J; Swanton, Laura L; Pavitt, Matthew J; Luo, Yuan-Ming; Backer, Vibeke; Polkey, Michael I; Hull, James H

2018-02-01

Exercise-induced laryngeal obstruction (EILO), a phenomenon in which the larynx closes inappropriately during physical activity, is a prevalent cause of exertional dyspnea in young individuals. The physiological ventilatory impact of EILO and its relationship to dyspnea are poorly understood. The objective of this study was to evaluate exercise-related changes in laryngeal aperture on ventilation, pulmonary mechanics, and respiratory neural drive. We prospectively evaluated 12 subjects (6 with EILO and 6 healthy age- and gender-matched controls). Subjects underwent baseline spirometry and a symptom-limited incremental exercise test with simultaneous and synchronized recording of endoscopic video and gastric, esophageal, and transdiaphragmatic pressures, diaphragm electromyography, and respiratory airflow. The EILO and control groups had similar peak work rates and minute ventilation (V̇e) (work rate: 227 ± 35 vs. 237 ± 35 W; V̇e: 103 ± 20 vs. 98 ± 23 l/min; P > 0.05). At submaximal work rates (140-240 W), subjects with EILO demonstrated increased work of breathing ( P respiratory neural drive ( P respiratory mechanics and diaphragm electromyography with endoscopic video, we demonstrate, for the first time, increased work of breathing and respiratory neural drive in association with the development of EILO. Future detailed investigations are now needed to understand the role of upper airway closure in causing exertional dyspnea and exercise limitation. NEW & NOTEWORTHY Exercise-induced laryngeal obstruction is a prevalent cause of exertional dyspnea in young individuals; yet, how laryngeal closure affects breathing is unknown. In this study we synchronized endoscopic video with respiratory physiological measurements, thus providing the first detailed commensurate assessment of respiratory mechanics and neural drive in relation to laryngeal closure. Laryngeal closure was associated with increased work of breathing and respiratory neural drive preceded by an

Automated respiratory support in newborn infants.

Science.gov (United States)

Claure, Nelson; Bancalari, Eduardo

2009-02-01

A considerable proportion of premature infants requires mechanical ventilatory support and supplemental oxygen. Due to their immaturity, exposure to these forms of respiratory support contributes to the development of lung injury, oxidative stress and abnormal retinal development. These conditions are associated with poor long-term respiratory and neurological outcome. Mechanically ventilated preterm infants present with frequent fluctuations in ventilation and gas exchange. Currently available ventilatory modes and manual adjustment to the ventilator or supplemental oxygen cannot effectively adapt to these recurrent fluctuations. Moreover, the respiratory support often exceeds the infant's real needs. Techniques that adapt the mechanical ventilatory support and supplemental oxygen to the changing needs of preterm infants are being developed in order to improve stability of gas exchange, to minimise respiratory support and to reduce personnel workload. This article describes the preliminary evidence on the application of these new techniques in preterm infants and animal models.

Patient presentation and physician management of upper respiratory tract infections: a retrospective review of over 5 million primary clinic consultations in Hong Kong.

Science.gov (United States)

Kung, Kenny; Wong, Carmen Ka Man; Wong, Samuel Yeung Shan; Lam, Augustine; Chan, Christy Ka Yan; Griffiths, Sian; Butler, Chris

2014-05-13

Upper respiratory tract infection (URTI) has a significant healthcare burden worldwide. Considerable resources are consumed through health care consultations and prescribed treatment, despite evidence for little or no effect on recovery. Patterns of consultations and care including use of symptomatic medications and antibiotics for upper respiratory tract infections are poorly described. We performed a retrospective review of computerized clinical data on patients presenting to all public primary care clinics in Hong Kong with symptoms of respiratory tract infections. International Classification of Primary care (ICPC)codes used to identify patients included otitis media (H71), streptococcal pharyngitis (R72), acute URTI (R74), acute sinusitis (R75), acute tonsillitis (R76), acute laryngitis (R77), and influenza (R80). Sociodemographic variables such as gender, age, chronic illness status, attendance date, type and duration of drug prescribed were also collected. Of the 5,529,755 primary care consultations for respiratory symptoms from 2005 to 2010, 98% resulted in a prescription. Prescription patterns of symptomatic medication were largely similar across the 5 years. In 2010 the mean number of drugs prescribed per consultation was 3.2, of which the commonly prescribed medication were sedating antihistamines (79.9%), analgesia (58.9%), throat lozenges (40.4%) and expectorant cough syrup (33.8%). During the study period, there was an overall decline in antibiotic prescription (8.1% to 5.1%). However, in consultations where the given diagnosis was otitis media (H71), streptococcal pharyngitis (R72), acute sinusitis (R75) or acute laryngitis (R76), over 90% resulted in antibiotic prescription. There was a decline in overall antibiotic prescription over the study period. However, the use of antibiotics was high in some conditions e.g. otitis media and acute laryngitis a. Multiple symptomatic medications were given for upper respiratory tract infections. Further

Occupational risk factors for chronic respiratory disease in a New Zealand population using lifetime occupational history.

NARCIS (Netherlands)

Hansell, A.; Ghosh, R.E.; Poole, S.; Zock, J.P.; Weatherall, M.; Vermeulen, R.; Kromhout, H.; Travers, J.; Beasley, R.

2014-01-01

Objectives: To investigate associations between respiratory disease and occupational exposures in a New Zealand urban population, the Wellington Respiratory Survey. Methods: Multiple regression analyses in a population sample of 1017 individuals aged 25 to 74 years with spirometry and questionnaire

An Official American Thoracic Society/European Respiratory Society Statement: Key Concepts and Advances in Pulmonary Rehabilitation

NARCIS (Netherlands)

Spruit, Martijn A.; Singh, Sally J.; Garvey, Chris; ZuWallack, Richard; Nici, Linda; Rochester, Carolyn; Hill, Kylie; Holland, Anne E.; Lareau, Suzanne C.; Man, W.D.C.; Pitta, Fabio; Sewell, Louise; Raskin, Jonathan; Bourbeau, Jean; Crouch, Rebecca; Franssen, Frits M.E.; Casaburi, Richard; Vercoulen, Jan H.; Vogiatzit, Ioannis; Gosselink, Rik; Clini, Enrico M.; Effing, T.W.; Maltais, Francois; van der Palen, Jacobus Adrianus Maria; Troosters, Thierry; Janssen, Daisy J.A.; Collins, Eileen; Garcia-Aymerich, Judith; Brooks, Dina; Fahy, Bonnie F.; Puhan, Milo A.; Hoogendoorn, Martine; Garrod, Rachel; Schols, Annemie M.W.J.; Carlin, Brian; Benzo, Roberto; Meek, Paula; Morgan, Mike; Rutten-van Mölken, Maureen P.M.H.; Ries, Andrew L.; Make, Barry; Goldstein, Roger S.; Dowson, Claire A.; Brozek, Jan L.; Donner, Claudio F.; Wouters, Emiel F.M.

2013-01-01

Background: Pulmonary rehabilitation is recognized as a core component of the management of individuals with chronic respiratory disease. Since the 2006 American Thoracic Society (ATS)/European Respiratory Society (ERS) Statement on Pulmonary Rehabilitation, there has been considerable growth in our

Respiratory signal analysis of liver cancer patients with respiratory-gated radiation therapy

International Nuclear Information System (INIS)

Kang, Dong Im; Jung, Sang Hoon; Kim, Chul Jong; Park, Hee Chul; Choi, Byung Ki

2015-01-01

External markers respiratory movement measuring device (RPM; Real-time Position Management, Varian Medical System, USA) Liver Cancer Radiation Therapy Respiratory gated with respiratory signal with irradiation time and the actual research by analyzing the respiratory phase with the breathing motion measurement device respiratory tuning evaluate the accuracy of radiation therapy May-September 2014 Novalis Tx. (Varian Medical System, USA) and liver cancer radiotherapy using respiratory gated RPM (Duty Cycle 20%, Gating window 40%-60%) of 16 patients who underwent total when recording the analyzed respiratory movement. After the breathing motion of the external markers recorded on the RPM was reconstructed by breathing through the acts phase analysis, for Beam-on Time and Duty Cycle recorded by using the reconstructed phase breathing breathing with RPM gated the prediction accuracy of the radiation treatment analysis and analyzed the correlation between prediction accuracy and Duty Cycle in accordance with the reproducibility of the respiratory movement. Treatment of 16 patients with respiratory cycle during the actual treatment plan was analyzed with an average difference -0.03 seconds (range -0.50 seconds to 0.09 seconds) could not be confirmed statistically significant difference between the two breathing (p = 0.472). The average respiratory period when treatment is 4.02 sec (0.71 sec), the average value of the respiratory cycle of the treatment was characterized by a standard deviation 7.43% (range 2.57 to 19.20%). Duty Cycle is that the actual average 16.05% (range 13.78 to 17.41%), average 56.05 got through the acts of the show and then analyzed% (range 39.23 to 75.10%) is planned in respiratory research phase (40% to 60%) in was confirmed. The investigation on the correlation between the ratio Duty Cycle and planned respiratory phase and the standard deviation of the respiratory cycle was analyzed in each -0.156 (p = 0.282) and -0.385 (p = 0.070). This study is

Incidence of respiratory viruses in Peruvian children with acute respiratory infections.

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del Valle Mendoza, Juana; Cornejo-Tapia, Angela; Weilg, Pablo; Verne, Eduardo; Nazario-Fuertes, Ronald; Ugarte, Claudia; del Valle, Luis J; Pumarola, Tomás

2015-06-01

Acute respiratory infections are responsible for high morbi-mortality in Peruvian children. However, the etiological agents are poorly identified. This study, conducted during the pandemic outbreak of H1N1 influenza in 2009, aims to determine the main etiological agents responsible for acute respiratory infections in children from Lima, Peru. Nasopharyngeal swabs collected from 717 children with acute respiratory infections between January 2009 and December 2010 were analyzed by multiplex RT-PCR for 13 respiratory viruses: influenza A, B, and C virus; parainfluenza virus (PIV) 1, 2, 3, and 4; and human respiratory syncytial virus (RSV) A and B, among others. Samples were also tested with direct fluorescent-antibodies (DFA) for six respiratory viruses. RT-PCR and DFA detected respiratory viruses in 240 (33.5%) and 85 (11.9%) cases, respectively. The most common etiological agents were RSV-A (15.3%), followed by influenza A (4.6%), PIV-1 (3.6%), and PIV-2 (1.8%). The viruses identified by DFA corresponded to RSV (5.9%) and influenza A (1.8%). Therefore, respiratory syncytial viruses (RSV) were found to be the most common etiology of acute respiratory infections. The authors suggest that active surveillance be conducted to identify the causative agents and improve clinical management, especially in the context of possible circulation of pandemic viruses. © 2015 Wiley Periodicals, Inc.

The microbiota of the respiratory tract : Gatekeeper to respiratory health

NARCIS (Netherlands)

Man, Wing Ho; De Steenhuijsen Piters, Wouter A.A.; Bogaert, Debby

2017-01-01

The respiratory tract is a complex organ system that is responsible for the exchange of oxygen and carbon dioxide. The human respiratory tract spans from the nostrils to the lung alveoli and is inhabited by niche-specific communities of bacteria. The microbiota of the respiratory tract probably acts

Treatment Failure and Mortality amongst Children with Severe Acute Malnutrition Presenting with Cough or Respiratory Difficulty and Radiological Pneumonia.

Directory of Open Access Journals (Sweden)

Mohammod Jobayer Chisti

Full Text Available Appropriate intervention is critical in reducing deaths among under-five, severe acutely malnourished (SAM children with danger signs of severe pneumonia; however, there is paucity of data on outcome of World Health Organisation (WHO recommended interventions of SAM children with severe pneumonia. We sought to evaluate outcome of the interventions in such children.We prospectively enrolled SAM children aged 0-59 months, admitted to the Intensive Care Unit (ICU or Acute Respiratory Infection (ARI ward of the Dhaka Hospital of the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b, between April 2011 and June 2012 with cough or respiratory difficulty and radiological pneumonia. All the enrolled children were treated with ampicillin and gentamicin, and micronutrients as recommended by the WHO. Comparison was made among pneumonic children with (n = 111 and without WHO defined danger signs of severe pneumonia (n = 296. The outcomes of interest were treatment failure (if a child required changing of antibiotics and deaths during hospitalization. Further comparison was also made among those who developed treatment failure and who did not and among the survivors and deaths.SAM children with danger signs of severe pneumonia more often experienced treatment failure (58% vs. 20%; p<0.001 and fatal outcome (21% vs. 4%; p<0.001 compared to those without danger signs. Only 6/111 (5.4% SAM children with danger signs of severe pneumonia and 12/296 (4.0% without danger signs had bacterial isolates from blood. In log-linear binomial regression analysis, after adjusting for potential confounders, danger signs of severe pneumonia, dehydration, hypocalcaemia, and bacteraemia were independently associated both with treatment failure and deaths in SAM children presenting with cough or respiratory difficulty and radiological pneumonia (p<0.01.The result suggests that SAM children with cough or respiratory difficulty and radiologic pneumonia who

Robust real-time extraction of respiratory signals from PET list-mode data.

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Salomon, Andre; Zhang, Bin; Olivier, Patrick; Goedicke, Andreas

2018-05-01

Respiratory motion, which typically cannot simply be suspended during PET image acquisition, affects lesions' detection and quantitative accuracy inside or in close vicinity to the lungs. Some motion compensation techniques address this issue via pre-sorting ("binning") of the acquired PET data into a set of temporal gates, where each gate is assumed to be minimally affected by respiratory motion. Tracking respiratory motion is typically realized using dedicated hardware (e.g. using respiratory belts and digital cameras). Extracting respiratory signalsdirectly from the acquired PET data simplifies the clinical workflow as it avoids to handle additional signal measurement equipment. We introduce a new data-driven method "Combined Local Motion Detection" (CLMD). It uses the Time-of-Flight (TOF) information provided by state-of-the-art PET scanners in order to enable real-time respiratory signal extraction without additional hardware resources. CLMD applies center-of-mass detection in overlapping regions based on simple back-positioned TOF event sets acquired in short time frames. Following a signal filtering and quality-based pre-selection step, the remaining extracted individual position information over time is then combined to generate a global respiratory signal. The method is evaluated using 7 measured FDG studies from single and multiple scan positions of the thorax region, and it is compared to other software-based methods regarding quantitative accuracy and statistical noise stability. Correlation coefficients around 90% between the reference and the extracted signal have been found for those PET scans where motion affected features such as tumors or hot regions were present in the PET field-of-view. For PET scans with a quarter of typically applied radiotracer doses, the CLMD method still provides similar high correlation coefficients which indicates its robustness to noise. Each CLMD processing needed less than 0.4s in total on a standard multi-core CPU

Robust real-time extraction of respiratory signals from PET list-mode data

Science.gov (United States)

Salomon, André; Zhang, Bin; Olivier, Patrick; Goedicke, Andreas

2018-06-01

Respiratory motion, which typically cannot simply be suspended during PET image acquisition, affects lesions’ detection and quantitative accuracy inside or in close vicinity to the lungs. Some motion compensation techniques address this issue via pre-sorting (‘binning’) of the acquired PET data into a set of temporal gates, where each gate is assumed to be minimally affected by respiratory motion. Tracking respiratory motion is typically realized using dedicated hardware (e.g. using respiratory belts and digital cameras). Extracting respiratory signals directly from the acquired PET data simplifies the clinical workflow as it avoids handling additional signal measurement equipment. We introduce a new data-driven method ‘combined local motion detection’ (CLMD). It uses the time-of-flight (TOF) information provided by state-of-the-art PET scanners in order to enable real-time respiratory signal extraction without additional hardware resources. CLMD applies center-of-mass detection in overlapping regions based on simple back-positioned TOF event sets acquired in short time frames. Following a signal filtering and quality-based pre-selection step, the remaining extracted individual position information over time is then combined to generate a global respiratory signal. The method is evaluated using seven measured FDG studies from single and multiple scan positions of the thorax region, and it is compared to other software-based methods regarding quantitative accuracy and statistical noise stability. Correlation coefficients around 90% between the reference and the extracted signal have been found for those PET scans where motion affected features such as tumors or hot regions were present in the PET field-of-view. For PET scans with a quarter of typically applied radiotracer doses, the CLMD method still provides similar high correlation coefficients which indicates its robustness to noise. Each CLMD processing needed less than 0.4 s in total on a standard

Respiratory Home Health Care

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... Us Home > Healthy Living > Living With Lung Disease > Respiratory Home Health Care Font: Aerosol Delivery Oxygen Resources ... Teenagers Living With Lung Disease Articles written by Respiratory Experts Respiratory Home Health Care Respiratory care at ...

Short-term effects of air pollution on lower respiratory diseases and forecasting by the group method of data handling

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Zhu, Wenjin; Wang, Jianzhou; Zhang, Wenyu; Sun, Donghuai

2012-05-01

Risk of lower respiratory diseases was significantly correlated with levels of monthly average concentration of SO2; NO2 and association rules have high lifts. In view of Lanzhou's special geographical location, taking into account the impact of different seasons, especially for the winter, the relations between air pollutants and the respiratory disease deserve further study. In this study the monthly average concentration of SO2, NO2, PM10 and the monthly number of people who in hospital because of lower respiratory disease from January 2001 to December 2005 are grouped equidistant and considered as the terms of transactions. Then based on the relational algebraic theory we employed the optimization relation association rule to mine the association rules of the transactions. Based on the association rules revealing the effects of air pollutants on the lower respiratory disease, we forecast the number of person who suffered from lower respiratory disease by the group method of data handling (GMDH) to reveal the risk and give a consultation to the hospital in Xigu District, the most seriously polluted district in Lanzhou. The data and analysis indicate that individuals may be susceptible to the short-term effects of pollution and thus suffer from lower respiratory diseases and this effect presents seasonal.

Inter-fraction variations in respiratory motion models

Energy Technology Data Exchange (ETDEWEB)

McClelland, J R; Modat, M; Ourselin, S; Hawkes, D J [Centre for Medical Image Computing, University College London (United Kingdom); Hughes, S; Qureshi, A; Ahmad, S; Landau, D B, E-mail: j.mcclelland@cs.ucl.ac.uk [Department of Oncology, Guy' s and St Thomas' s Hospitals NHS Trust, London (United Kingdom)

2011-01-07

Respiratory motion can vary dramatically between the planning stage and the different fractions of radiotherapy treatment. Motion predictions used when constructing the radiotherapy plan may be unsuitable for later fractions of treatment. This paper presents a methodology for constructing patient-specific respiratory motion models and uses these models to evaluate and analyse the inter-fraction variations in the respiratory motion. The internal respiratory motion is determined from the deformable registration of Cine CT data and related to a respiratory surrogate signal derived from 3D skin surface data. Three different models for relating the internal motion to the surrogate signal have been investigated in this work. Data were acquired from six lung cancer patients. Two full datasets were acquired for each patient, one before the course of radiotherapy treatment and one at the end (approximately 6 weeks later). Separate models were built for each dataset. All models could accurately predict the respiratory motion in the same dataset, but had large errors when predicting the motion in the other dataset. Analysis of the inter-fraction variations revealed that most variations were spatially varying base-line shifts, but changes to the anatomy and the motion trajectories were also observed.

Practical approach to management of respiratory complications in neurological disorders

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Mangera Z

2012-03-01

Full Text Available Zaheer Mangera, Kirat Panesar, Himender MakkerRespiratory Medicine, North Middlesex University Hospital, London, UKAbstract: Patients with certain neurological diseases are at increased risk of developing chest infections as well as respiratory failure due to muscular weakness. In particular, patients with certain neuromuscular disorders are at higher risk. These conditions are often associated with sleep disordered breathing. It is important to identify patients at risk of respiratory complications early in the course of their disease, although patients with neuromuscular disorders often present in the acute setting with respiratory involvement. This review of the respiratory complications of neurological disorders, with a particular focus on neuromuscular disorders, explores why this happens and looks at how to recognize, investigate, and manage these patients effectively.Keywords: respiratory failure, respiratory muscle weakness

Excluding infection through procalcitonin testing improves outcomes of congestive heart failure patients presenting with acute respiratory symptoms: results from the randomized ProHOSP trial.

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Schuetz, Philipp; Kutz, Alexander; Grolimund, Eva; Haubitz, Sebastian; Demann, Désirée; Vögeli, Alaadin; Hitz, Fabienne; Christ-Crain, Mirjam; Thomann, Robert; Falconnier, Claudine; Hoess, Claus; Henzen, Christoph; Marlowe, Robert J; Zimmerli, Werner; Mueller, Beat

2014-08-20

We sought to determine whether exclusion of infection and antibiotic stewardship with the infection biomarker procalcitonin improves outcomes in congestive heart failure (CHF) patients presenting to emergency departments with respiratory symptoms and suspicion of respiratory infection. We performed a secondary analysis of patients with a past medical history of CHF formerly included in a Swiss multicenter randomized-controlled trial. The trial compared antibiotic stewardship according to a procalcitonin algorithm or state-of-the-art guidelines (controls). The primary endpoint was a 30-day adverse outcome (death, intensive care unit admission); the secondary endpoints included a 30-day antibiotic exposure. In the 110/233 analyzed patients (47.2%) with low initial procalcitonin (<0.25 μg/L), suggesting the absence of systemic bacterial infection, those randomized to procalcitonin guidance (n=50) had a significantly lower adverse outcome rate compared to controls (n=60): 4% vs. 20% (absolute difference -16.0%, 95% confidence interval (CI) -28.4% to -3.6%, P=0.01), and significantly reduced antibiotic exposure [days] (mean 3.7 ± 4.0 vs. 6.5 ± 4.4, difference -2.8 [95% CI, -4.4 to -1.2], P<0.01). When initial procalcitonin was ≥0.25 μg/L, procalcitonin-guided patients had significantly reduced antibiotic exposure due to early stop of therapy without any difference in adverse outcomes (25.8% vs. 24.6%, difference [95% CI] 1.2% [-14.5% to 16.9%, P=0.88]). CHF patients presenting to the emergency department with respiratory symptoms and suspicion for respiratory infection had decreased antibiotic exposure and improved outcomes when procalcitonin measurement was used to exclude bacterial infection and guide antibiotic treatment. These data provide further evidence for the potential harmful effects of antibiotic / fluid treatment when used instead of diuretics and heart failure medication in clinically symptomatic CHF patients without underlying infection. Copyright �

Comparison between late-presenting and isolated neonatal ...

African Journals Online (AJOL)

Results: Isolated neonatal cases presented more often with acute respiratory symptoms (n=25; P= 0.016) and failure to thrive (n= 38; P= 0.03). Late-presenting cases presented more often with chronic respiratory symptoms (n=14; P= 0.0044) or gastrointestinal symptoms (n=12; P= 0.006). Thirty-five cases with minor or ...

[Respiratory infections caused by metapneumovirus in elderly patients].

Science.gov (United States)

Fica C, Alberto; Hernández C, Loreto; Porte T, Lorena; Castro S, Marcelo; Weitzel, Thomas

2011-04-01

Human metapneumovirus infections are increasingly recognized among adult patients and the aim of this report is to present a series of 4 cases admitted during the winter of 2010. All were detected by direct fluorescence anti-bodies assay of respiratory samples and all were female patients with an age range of 79 to 95 years, including two bedridden cases, one with dementia and three with chronic obstructive pulmonary disease. One patient presented with parainfluenza 3 virus coinfection. Patients presented with pneumonía in 3 cases (interstitial pattern in 2 and lobar consolidation in the other) or acute exacerbation of chronic bronchitis in the remaining case. Symptoms were present for 3 to 7 days before admission and 3 have wheezing. All had hypoxemic or global respiratory failure and lymphopenia (ventilation. Human metapneumovirus infections can decompensate elderly patients with chronic respiratory diseases generating hospital admission and a prolonged morbidity marked by obstructive manifestations and sometimes can become into death.

Lung injury and respiratory mechanics in rugby union.

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Lindsay, Angus; Bernard, Angelique; Davidson, Shaun M; Redmond, Daniel P; Chiew, Yeong S; Pretty, Christopher; Chase, J Geoffrey; Shaw, Geoffrey M; Gieseg, Steven P; Draper, Nick

2016-04-01

Rugby is a highly popular team contact sport associated with high injury rates. Specifically, there is a chance of inducing internal lung injuries as a result of the physical nature of the game. Such injuries are only identified with the use of specific invasive protocols or equipment. This study presents a model-based method to assess respiratory mechanics of N=11 rugby players that underwent a low intensity experimental Mechanical Ventilation (MV) Test before and after a rugby game. Participants were connected to a ventilator via a facemask and their respiratory mechanics estimated using a time-varying elastance model. All participants had a respiratory elastance respiratory mechanics (P>0.05). Model-based respiratory mechanics estimation has been used widely in the treatment of the critically ill in intensive care. However, the application of a ventilator to assess the respiratory mechanics of healthy human beings is limited. This method adapted from ICU mechanical ventilation can be used to provide insight to respiratory mechanics of healthy participants that can be used as a more precise measure of lung inflammation/injury that avoids invasive procedures. This is the first study to conceptualize the assessment of respiratory mechanics in healthy athletes as a means to monitor postexercise stress and therefore manage recovery.

Personalized Medicine for Chronic Respiratory Infectious Diseases: Tuberculosis, Nontuberculous Mycobacterial Pulmonary Diseases, and Chronic Pulmonary Aspergillosis.

Science.gov (United States)

Salzer, Helmut J F; Wassilew, Nasstasja; Köhler, Niklas; Olaru, Ioana D; Günther, Gunar; Herzmann, Christian; Kalsdorf, Barbara; Sanchez-Carballo, Patricia; Terhalle, Elena; Rolling, Thierry; Lange, Christoph; Heyckendorf, Jan

2016-01-01

Chronic respiratory infectious diseases are causing high rates of morbidity and mortality worldwide. Tuberculosis, a major cause of chronic pulmonary infection, is currently responsible for approximately 1.5 million deaths per year. Although important advances in the fight against tuberculosis have been made, the progress towards eradication of this disease is being challenged by the dramatic increase in multidrug-resistant bacilli. Nontuberculous mycobacteria causing pulmonary disease and chronic pulmonary aspergillosis are emerging infectious diseases. In contrast to other infectious diseases, chronic respiratory infections share the trait of having highly variable treatment outcomes despite longstanding antimicrobial therapy. Recent scientific progress indicates that medicine is presently at a transition stage from programmatic to personalized management. We explain current state-of-the-art management concepts of chronic pulmonary infectious diseases as well as the underlying methods for therapeutic decisions and their implications for personalized medicine. Furthermore, we describe promising biomarkers and techniques with the potential to serve future individual treatment concepts in this field of difficult-to-treat patients. These include candidate markers to improve individual risk assessment for disease development, the design of tailor-made drug therapy regimens, and individualized biomarker-guided therapy duration to achieve relapse-free cure. In addition, the use of therapeutic drug monitoring to reach optimal drug dosing with the smallest rate of adverse events as well as candidate agents for future host-directed therapies are described. Taken together, personalized medicine will provide opportunities to substantially improve the management and treatment outcome of difficult-to-treat patients with chronic respiratory infections. © 2016 S. Karger AG, Basel.

Respiratory motion management using audio-visual biofeedback for respiratory-gated radiotherapy of synchrotron-based pulsed heavy-ion beam delivery

International Nuclear Information System (INIS)

He, Pengbo; Ma, Yuanyuan; Huang, Qiyan; Yan, Yuanlin; Li, Qiang; Liu, Xinguo; Dai, Zhongying; Zhao, Ting; Fu, Tingyan; Shen, Guosheng

2014-01-01

Purpose: To efficiently deliver respiratory-gated radiation during synchrotron-based pulsed heavy-ion radiotherapy, a novel respiratory guidance method combining a personalized audio-visual biofeedback (BFB) system, breath hold (BH), and synchrotron-based gating was designed to help patients synchronize their respiratory patterns with synchrotron pulses and to overcome typical limitations such as low efficiency, residual motion, and discomfort. Methods: In-house software was developed to acquire body surface marker positions and display BFB, gating signals, and real-time beam profiles on a LED screen. Patients were prompted to perform short BHs or short deep breath holds (SDBH) with the aid of BFB following a personalized standard BH/SDBH (stBH/stSDBH) guiding curve or their own representative BH/SDBH (reBH/reSDBH) guiding curve. A practical simulation was performed for a group of 15 volunteers to evaluate the feasibility and effectiveness of this method. Effective dose rates (EDRs), mean absolute errors between the guiding curves and the measured curves, and mean absolute deviations of the measured curves were obtained within 10%–50% duty cycles (DCs) that were synchronized with the synchrotron’s flat-top phase. Results: All maneuvers for an individual volunteer took approximately half an hour, and no one experienced discomfort during the maneuvers. Using the respiratory guidance methods, the magnitude of residual motion was almost ten times less than during nongated irradiation, and increases in the average effective dose rate by factors of 2.39–4.65, 2.39–4.59, 1.73–3.50, and 1.73–3.55 for the stBH, reBH, stSDBH, and reSDBH guiding maneuvers, respectively, were observed in contrast with conventional free breathing-based gated irradiation, depending on the respiratory-gated duty cycle settings. Conclusions: The proposed respiratory guidance method with personalized BFB was confirmed to be feasible in a group of volunteers. Increased effective dose

Respiratory motion management using audio-visual biofeedback for respiratory-gated radiotherapy of synchrotron-based pulsed heavy-ion beam delivery

Energy Technology Data Exchange (ETDEWEB)

He, Pengbo; Ma, Yuanyuan; Huang, Qiyan; Yan, Yuanlin [Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000 (China); Key Laboratory of Heavy Ion Radiation Biology and Medicine of Chinese Academy of Sciences, Lanzhou 730000 (China); School of Life Sciences, University of Chinese Academy of Sciences, Beijing 100049 (China); Li, Qiang, E-mail: liqiang@impcas.ac.cn; Liu, Xinguo; Dai, Zhongying; Zhao, Ting; Fu, Tingyan; Shen, Guosheng [Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000 (China); Key Laboratory of Heavy Ion Radiation Biology and Medicine of Chinese Academy of Sciences, Lanzhou 730000 (China)

2014-11-01

Purpose: To efficiently deliver respiratory-gated radiation during synchrotron-based pulsed heavy-ion radiotherapy, a novel respiratory guidance method combining a personalized audio-visual biofeedback (BFB) system, breath hold (BH), and synchrotron-based gating was designed to help patients synchronize their respiratory patterns with synchrotron pulses and to overcome typical limitations such as low efficiency, residual motion, and discomfort. Methods: In-house software was developed to acquire body surface marker positions and display BFB, gating signals, and real-time beam profiles on a LED screen. Patients were prompted to perform short BHs or short deep breath holds (SDBH) with the aid of BFB following a personalized standard BH/SDBH (stBH/stSDBH) guiding curve or their own representative BH/SDBH (reBH/reSDBH) guiding curve. A practical simulation was performed for a group of 15 volunteers to evaluate the feasibility and effectiveness of this method. Effective dose rates (EDRs), mean absolute errors between the guiding curves and the measured curves, and mean absolute deviations of the measured curves were obtained within 10%–50% duty cycles (DCs) that were synchronized with the synchrotron’s flat-top phase. Results: All maneuvers for an individual volunteer took approximately half an hour, and no one experienced discomfort during the maneuvers. Using the respiratory guidance methods, the magnitude of residual motion was almost ten times less than during nongated irradiation, and increases in the average effective dose rate by factors of 2.39–4.65, 2.39–4.59, 1.73–3.50, and 1.73–3.55 for the stBH, reBH, stSDBH, and reSDBH guiding maneuvers, respectively, were observed in contrast with conventional free breathing-based gated irradiation, depending on the respiratory-gated duty cycle settings. Conclusions: The proposed respiratory guidance method with personalized BFB was confirmed to be feasible in a group of volunteers. Increased effective dose

Increased vocal intensity due to the Lombard effect in speakers with Parkinson's disease: simultaneous laryngeal and respiratory strategies.

Science.gov (United States)

Stathopoulos, Elaine T; Huber, Jessica E; Richardson, Kelly; Kamphaus, Jennifer; DeCicco, Devan; Darling, Meghan; Fulcher, Katrina; Sussman, Joan E

2014-01-01

The objective of the present study was to investigate whether speakers with hypophonia, secondary to Parkinson's disease (PD), would increases their vocal intensity when speaking in a noisy environment (Lombard effect). The other objective was to examine the underlying laryngeal and respiratory strategies used to increase vocal intensity. Thirty-three participants with PD were included for study. Each participant was fitted with the SpeechVive™ device that played multi-talker babble noise into one ear during speech. Using acoustic, aerodynamic and respiratory kinematic techniques, the simultaneous laryngeal and respiratory mechanisms used to regulate vocal intensity were examined. Significant group results showed that most speakers with PD (26/33) were successful at increasing their vocal intensity when speaking in the condition of multi-talker babble noise. They were able to support their increased vocal intensity and subglottal pressure with combined strategies from both the laryngeal and respiratory mechanisms. Individual speaker analysis indicated that the particular laryngeal and respiratory interactions differed among speakers. The SpeechVive™ device elicited higher vocal intensities from patients with PD. Speakers used different combinations of laryngeal and respiratory physiologic mechanisms to increase vocal intensity, thus suggesting that disease process does not uniformly affect the speech subsystems. Readers will be able to: (1) identify speech characteristics of people with Parkinson's disease (PD), (2) identify typical respiratory strategies for increasing sound pressure level (SPL), (3) identify typical laryngeal strategies for increasing SPL, (4) define the Lombard effect. Copyright © 2014 Elsevier Inc. All rights reserved.

OBSTRUCTION OF THE RESPIRATORY TRACT DURING THE GENERAL ANESTHESIA AT CHILDRENS AGE

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Verica Djordjevic

2001-01-01

Full Text Available The respiratory complications before, during and after applying the generalanesthesia still represent -despicable the introduction of new anesthetics and new musclerelaxants, modern monitoring and treatment - an importanl potential causc ofmorbidilv and mortality. This particularly refers to the pediatric patients having highminulc ventilation with regard to the functional residual capacity coupled with greatoxygen use; it very quickly leads to hypoxemia. Thc causcs of the respiratorycomplications can be various, but in essence they involve venlilation depression.respiratory tract obstruction or an inadequate oxygen supplv. These sales appeareither individually or in any combination. The causcs of thc respiratory tractobstruction ore numerous and various: they can be divided into physiological andpathological.

Predictive Value of Respiratory Rate Thresholds in Pneumonia ...

African Journals Online (AJOL)

A study was carried out to determine the predictive value of respiratory rate in the clinical diagnosis of pneumonia in 101 children with respiratory symptoms of <28 days duration. Clinical, demographic and anthropometric variables were obtained at presentation while confirmation of the diagnosis was by a chest x-ray in ...

Mild respiratory symptoms in asthmatic patients might not be due to bronchoconstriction

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Tarig H Merghani

2017-01-01

CONCLUSION: About 11% of asthmatic patients with mild respiratory symptoms who attended the respiratory clinic have no evidence of bronchoconstriction. Spirometry is an essential step for evaluation of every asthmatic patient who presents with respiratory symptoms.

Assessment of a strategy for the control of respiratory diseases in children

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Pereira Julio Cesar Rodrigues

1992-01-01

Full Text Available A programme for the control of respiratory diseases in children was conceived for the State of S. Paulo, Brazil, in 1986. Its progress thereafter and the epidemiology of the diseases concerned are examined. Apart from an inquiry into the 64 existing State local health authorities, a sample of 18,255 cases of children assisted by the programme at different levels, including both in-patient and outpatient care, is analysed. Each case record included information about identification (child, doctor and health facility, reasons for calling, diagnoses made and outcome of treatment. Further data were also sought from hospitals and from State mortality records. The programme was found to be poorly implemented in the State but, where implemented, it showed itself capable of resolving problems (only 0.5% of the cases could not be handled as also of changing ongoing trends (more than 50% reduction in hospital admission rates. Individual assessment of each item of the programme indicated its bottlenecks. Regarding the epidemiology of respiratory diseases, it is observed that the major burden to health services comes from children aged less than five, and that the most important diseases are wheezing illnesses and pneumonia. Morevoer, they were found to be significantly associated (p = 0.000 so that a child in the community presenting wheezing diseases is 5 times more likely to develop pneumonia than a child with any other respiratory diagnosis. Similarly, among the under five deaths it was found that the risk for pneumonia is 3 times greater for children who died presenting wheezing diseases than it is for children with any other sort of diagnosis. In conclusion, the programme is deemed to be efficient and effective but its efficacy is marred by administrative flaws. The successful control of respiratory problems in childhood is related to a proper appreciation of the importance of wheezing diseases.

Respiratory Failure

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Respiratory failure happens when not enough oxygen passes from your lungs into your blood. Your body's organs, ... brain, need oxygen-rich blood to work well. Respiratory failure also can happen if your lungs can' ...

Respiratory system

Science.gov (United States)

Bartlett, R. G., Jr.

1973-01-01

The general anatomy and function of the human respiratory system is summarized. Breathing movements, control of breathing, lung volumes and capacities, mechanical relations, and factors relevant to respiratory support and equipment design are discussed.

Respiratory manifestations in 38 patients with Alström syndrome.

Science.gov (United States)

Boerwinkle, Caroline; Marshall, Jan D; Bryant, Joy; Gahl, William A; Olivier, Kenneth N; Gunay-Aygun, Meral

2017-04-01

Alström syndrome (AS) is a rare, multi-system condition characterized by retinal degeneration, sensorineural hearing loss, obesity, insulin-resistant diabetes, hypertriglyceridemia, cardiomyopathy, hepatorenal disease, and recurrent respiratory infections. It belongs to a group of genetic disorders known as primary ciliopathies, which includes autosomal dominant and recessive polycystic kidney diseases, as well as Joubert and Bardet-Biedl syndromes. Prior studies have suggested phenotypic overlap between primary ciliopathies affecting the non-motile, sensory cilia, and primary ciliary dyskinesia (PCD), a motile ciliopathy characterized by respiratory tract disease. We describe the burden of oto-sino-pulmonary disease in 38 individuals with AS and examines the degree of clinical overlap between PCD and AS. Evaluation at the NIH Clinical Center included clinical examination, chest imaging, and clinical history surveys, as well as measurement of nasal nitric oxide (nNO) in nine patients. Recurrent otitis media was ubiquitous in the AS cohort (92%) with 50% requiring pressure equalization tube placement. A history of bronchitis/pneumonia and sinusitis was reported in 61% and 50% of individuals, respectively. PCD-characterizing symptoms (laterality defects, unexplained neonatal respiratory distress, year-round nasal congestion, and wet cough) were far less prevalent in the AS cohort compared to PCD, and the average nNO production in the AS cohort was 232 ± 57.1 nl/min compared to a cut-off of <77 nl/min for PCD. These data suggest that the oto-sino-respiratory complications in AS are prominent enough to warrant increased clinical attention, but significantly impaired respiratory cilia function as seen in PCD is unlikely in AS. (www.clinicaltrials.gov, trial NCT00068224) Pediatr Pulmonol. 2017;52:487-493. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Acceptable respiratory protection program and LASL respirator research

International Nuclear Information System (INIS)

Skaggs, B.J.

1979-01-01

A short history is presented on the LASL Respiratory Protection Training Programs. Then a discussion is given on the major points of an acceptable respiratory protection program utilizing the points required by the Occupational, Safety, and Health Administration (OSHA) Regulation 29 CFR 1910.134. Contributions to respirator research are reviewed. Discussion is presented under the following section headings: program administration; respirator selection; respirator use; fitting and training; respirator maintenance; medical clearance and surveillance; special problems; program evaluation; and documentation

Epidemiology of pathogen-specific respiratory infections among three US populations.

Directory of Open Access Journals (Sweden)

Jennifer M Radin

Full Text Available Diagnostic tests for respiratory infections can be costly and time-consuming. Improved characterization of specific respiratory pathogens by identifying frequent signs, symptoms and demographic characteristics, along with improving our understanding of coinfection rates and seasonality, may improve treatment and prevention measures.Febrile respiratory illness (FRI and severe acute respiratory infection (SARI surveillance was conducted from October 2011 through March 2013 among three US populations: civilians near the US-Mexico border, Department of Defense (DoD beneficiaries, and military recruits. Clinical and demographic questionnaire data and respiratory swabs were collected from participants, tested by PCR for nine different respiratory pathogens and summarized. Age stratified characteristics of civilians positive for influenza and recruits positive for rhinovirus were compared to other and no/unknown pathogen. Seasonality and coinfection rates were also described.A total of 1444 patients met the FRI or SARI case definition and were enrolled in this study. Influenza signs and symptoms varied across age groups of civilians. Recruits with rhinovirus had higher percentages of pneumonia, cough, shortness of breath, congestion, cough, less fever and longer time to seeking care and were more likely to be male compared to those in the no/unknown pathogen group. Coinfections were found in 6% of all FRI/SARI cases tested and were most frequently seen among children and with rhinovirus infections. Clear seasonal trends were identified for influenza, rhinovirus, and respiratory syncytial virus.The age-stratified clinical characteristics associated with influenza suggest that age-specific case definitions may improve influenza surveillance and identification. Improving identification of rhinoviruses, the most frequent respiratory infection among recruits, may be useful for separating out contagious individuals, especially when larger outbreaks occur

Tei index in neonatal respiratory distress and perinatal asphyxia

OpenAIRE

Ahmed Anwer Attia Khattab

2015-01-01

Cardiovascular compromise is a common complication of neonatal respiratory distress and perinatal asphyxia. Tei index is a Doppler-derived index for the assessment of overall left ventricular function that combines systolic and diastolic time intervals. Aim: Assess the role of MPI versus cardiac troponin I as early indicator of hypoxic cardiac damage in neonates with respiratory distress or perinatal asphyxia. The present work was conducted on forty neonates, 15 with neonatal respiratory dist...

Textbook of respiratory medicine

International Nuclear Information System (INIS)

Murray, J.F.; Nadel, J.

1987-01-01

This book presents a clinical reference of respiratory medicine. It also details basic science aspects of pulmonary physiology and describes recently developed, sophisticated diagnostic tools and therapeutic methods. It also covers anatomy, physiology, pharmacology, and pathology; microbiologic, radiologic, nuclear medicine, and biopsy methods for diagnosis

Respiratory disorders in patients with polymyositis/dermatomyositis

Directory of Open Access Journals (Sweden)

Olga Alekseyevna Antelava

2014-01-01

Full Text Available Idiopathic inflammatory myopathies (IIM are rare disorders characterized by inflammatory lesions in skeletal muscles. These diseases include polymyositis (PM, dermatomyositis (DM, and inclusion body myositis, which exhibit clinicoimmunological heterogeneity and give different response to therapy. The most frequent manifestation in PM/DM patients is respiratory system dysfunction. The developing respiratory disorders are varied and may outpace the presentation of muscle pathology.

Middle East Respiratory Syndrome

Centers for Disease Control (CDC) Podcasts

2014-07-07

This podcast discusses Middle East Respiratory Syndrome, or MERS, a viral respiratory illness caused by Middle East Respiratory Syndrome Coronavirus—MERS-CoV.  Created: 7/7/2014 by National Center for Immunization and Respiratory Diseases (NCIRD).   Date Released: 7/7/2014.

Respiratory Syncytial Virus Bronchiolitis in Children.

Science.gov (United States)

Smith, Dustin K; Seales, Sajeewane; Budzik, Carol

2017-01-15

Bronchiolitis is a common lower respiratory tract infection in infants and young children, and respiratory syncytial virus (RSV) is the most common cause of this infection. RSV is transmitted through contact with respiratory droplets either directly from an infected person or self-inoculation by contaminated secretions on surfaces. Patients with RSV bronchiolitis usually present with two to four days of upper respiratory tract symptoms such as fever, rhinorrhea, and congestion, followed by lower respiratory tract symptoms such as increasing cough, wheezing, and increased respiratory effort. In 2014, the American Academy of Pediatrics updated its clinical practice guideline for diagnosis and management of RSV bronchiolitis to minimize unnecessary diagnostic testing and interventions. Bronchiolitis remains a clinical diagnosis, and diagnostic testing is not routinely recommended. Treatment of RSV infection is mainly supportive, and modalities such as bronchodilators, epinephrine, corticosteroids, hypertonic saline, and antibiotics are generally not useful. Evidence supports using supplemental oxygen to maintain adequate oxygen saturation; however, continuous pulse oximetry is no longer required. The other mainstay of therapy is intravenous or nasogastric administration of fluids for infants who cannot maintain their hydration status with oral fluid intake. Educating parents on reducing the risk of infection is one of the most important things a physician can do to help prevent RSV infection, especially early in life. Children at risk of severe lower respiratory tract infection should receive immunoprophylaxis with palivizumab, a humanized monoclonal antibody, in up to five monthly doses. Prophylaxis guidelines are restricted to infants born before 29 weeks' gestation, infants with chronic lung disease of prematurity, and infants and children with hemodynamically significant heart disease.

Viral respiratory diseases: vaccines and antivirals.

Science.gov (United States)

Lennette, E H

1981-01-01

Acute respiratory diseases, most of which are generally attributed to viruses, account for about 6% of all deaths and for about 60% of the deaths associated with all respiratory disease. The huge cost attributable to viral respiratory infections as a result of absenteeism and the disruption of business and the burden of medical care makes control of these diseases an important objective. The viruses that infect the respiratory tract fall taxonomically into five viral families. Although immunoprophylaxis would appear to be the logical approach, the development of suitable vaccines has been confronted with numerous obstacles, including antigenic drift and shift in the influenzaviruses, the large number of antigenically distinct immunotypes among rhinoviruses, the occurrence after immunization of rare cases of a severe form of the disease following subsequent natural infection with respiratory syncytial virus, and the risk of oncogenicity of adenoviruses for man. Considerable expenditure on the development of new antiviral drugs has so far resulted in only three compounds that are at present officially approved and licensed for use in the USA. Efforts to improve the tools available for control should continue and imaginative and inventive approaches are called for. However, creativity and ingenuity must operate within the constraints imposed by economic, political, ethical, and legal considerations.

DNA damage in healthy individuals and respiratory patients after treating whole blood in vitro with the bulk and nano forms of NSAIDs

Directory of Open Access Journals (Sweden)

Diana Anderson

2016-09-01

Full Text Available Non-steroidal anti-inflammatory drugs (NSAIDs inhibit COX enzyme activity which affects the inflammatory response. Inflammation is associated with increasing cancer incidence. Pre-clinical and clinical studies have shown that NSAID treatment could cause an anti-tumour effect in cancers. In the present study, blood was taken from healthy individuals (n=17 and patients with respiratory diseases or lung cancer (n=36. White blood cells (WBC were treated with either a micro-suspension, i.e. bulk (B or nano-suspension (N of aspirin (ASP or ibuprofen (IBU up to 500 µg/ml in the comet assay and up to 125 µg/ml in the micronucleus assay. In this study results were compared against untreated lymphocytes and their corresponding treated groups. The results showed, thgat NSAIDs in their nano form significantly reduced the DNA damage in WBCs from lung cancer patients in bulk and nano compared to untreated lymphocytes. Also, there was a decrease in the level of DNA damage in the comet assay after treating WBCs from healthy individuals, asthma and COPD groups with aspirin N (ASP N but not with IBU N. In addition, the number of micronuclei decreased after treatment with NSAIDs in their nano form (ASP N and IBU N in the healthy as well as in the lung cancer group. However, this was not the case for micronucleus frequency in asthma and COPD patients. These data show that lymphocytes from different groups respond differently to treatment with ASP and IBU as measured by comet assay and micronucleus assay, and that the size of the suspended particles of the drugs affects responses.

[Two patients with mitochondrial respiratory chain disease].

Science.gov (United States)

Bangma, H R; Smit, G P A; Kuks, J B M; Grevink, R G; Wolffenbuttel, B H R

2008-10-18

A 23-year-old woman and a 13-year-old boy were diagnosed with mitochondrial respiratory chain disease. The woman had muscle pain, fatigue and bilateral ophthalmoplegia--symptoms consistent with Kearns-Sayre syndrome. The boy had aspecific symptoms; eventually, reduced activity of complex 1 was found to be the cause of the mitochondrial respiratory chain disease in the boy and his mother, who had suffered from unexplained fatigue and muscle pain for 15 years. Mitochondrial diseases often involve several organ systems. Diagnosis can be difficult, because laboratory tests such as serum and urinary lactate and creatine kinase have low sensitivity and specificity. Biochemical assessment of muscle biopsy can reveal reduced oxidation ATP synthesis and sometimes specific abnormalities in individual protein complexes. DNA analysis may be helpful in demonstrating mitochondrial or nuclear mutations or deletions. The goal of treatment is to increase mitochondrial ATP production, improve clinical symptoms and enhance stamina. Replacement of the following substances (also referred to as cofactors) may be attempted: co-enzyme Q10, antioxidants (lipoic acid, vitamins C and E), riboflavin, thiamine, creatine and carnitine. Evidence regarding the optimal treatment approach is lacking; one usually has to rely on observing effects in the individual patient.

Non-invasive measure of respiratory mechanics and conventional respiratory parameters in conscious large animals by high frequency Airwave Oscillometry.

Science.gov (United States)

Bassett, Leanne; Troncy, Eric; Robichaud, Annette; Schuessler, Thomas F; Pouliot, Mylène; Ascah, Alexis; Authier, Simon

2014-01-01

A number of drugs in clinical trials are discontinued due to potentially life-threatening airway obstruction. As some drugs may not cause changes in core battery parameters such as tidal volume (Vt), respiratory rate (RR) or minute ventilation (MV), including measurements of respiratory mechanics in safety pharmacology studies represents an opportunity for design refinement. The present study aimed to test a novel non-invasive methodology to concomitantly measure respiratory system resistance (Rrs) and conventional respiratory parameters (Vt, RR, MV) in conscious Beagle dogs and cynomolgus monkeys. An Airwave Oscillometry system (tremoFlo; THORASYS Inc., Montreal, Canada) was used to concomitantly assess Rrs and conventional respiratory parameters before and after intravenous treatment with a bronchoactive agent. Respiratory mechanics measurements were performed by applying a short (i.e. 16s) single high frequency (19Hz) waveform at the subject's airway opening via a face mask. During measurements, pressure and flow signals were recorded. After collection of baseline measurements, methacholine was administered intravenously to Beagle dogs (n=6) and cynomolgus monkeys (n=4) at 8 and 68μg/kg, respectively. In dogs, methacholine induced significant increases in Vt, RR and MV while in monkeys, it only augmented RR. A significant increase in Rrs was observed after methacholine administration in both species with mean percentage peak increases from baseline of 88 (53)% for dogs and 28 (16)% for cynomolgus monkeys. Airwave Oscillometry appears to be a promising non-invasive methodology to enable respiratory mechanics measurements in conscious large animals, a valuable refinement in respiratory safety pharmacology. Copyright © 2014 Elsevier Inc. All rights reserved.

Respiratory Symptoms in Firefighters

NARCIS (Netherlands)

Greven, Frans E.; Rooyackers, Jos M.; Kerstjens, Huib A. M.; Heederik, Dick J.

Background The aim of the present study was to determine the prevalence and risk factors associated with respiratory symptoms in common firefighters in the Netherlands. Methods A total of 1,330 firefighters from the municipal fire brigades of three provinces of the Netherlands were included in the

Human herpesviruses respiratory infections in patients with acute respiratory distress (ARDS).

Science.gov (United States)

Bonizzoli, Manuela; Arvia, Rosaria; di Valvasone, Simona; Liotta, Francesco; Zakrzewska, Krystyna; Azzi, Alberta; Peris, Adriano

2016-08-01

Acute respiratory distress syndrome (ARDS) is today a leading cause of hospitalization in intensive care unit (ICU). ARDS and pneumonia are closely related to critically ill patients; however, the etiologic agent is not always identified. The presence of human herpes simplex virus 1, human cytomegalovirus and Epstein-Barr virus in respiratory samples of critically ill patients is increasingly reported even without canonical immunosuppression. The main aim of this study was to better understand the significance of herpesviruses finding in lower respiratory tract of ARDS patients hospitalized in ICU. The presence of this group of herpesviruses, in addition to the research of influenza viruses and other common respiratory viruses, was investigated in respiratory samples from 54 patients hospitalized in ICU, without a known microbiological causative agent. Moreover, the immunophenotype of each patient was analyzed. Herpesviruses DNA presence in the lower respiratory tract seemed not attributable to an impaired immunophenotype, whereas a significant correlation was observed between herpesviruses positivity and influenza virus infection. A higher ICU mortality was significantly related to the presence of herpesvirus infection in the lower respiratory tract as well as to impaired immunophenotype, as patients with poor outcome showed severe lymphopenia, affecting in particular T (CD3+) cells, since the first days of ICU hospitalization. In conclusion, these results indicate that herpesviruses lower respiratory tract infection, which occurs more frequently following influenza virus infection, can be a negative prognostic marker. An independent risk factor for ICU patients with ARDS is an impaired immunophenotype.

Mobilisation of toxic elements in the human respiratory system

International Nuclear Information System (INIS)

Pinheiro, T.; Alves, L.C.; Palhano, M.J.; Bugalho de Almeida, A.

2001-01-01

The fate of respired particles in the respiratory system is inferred through the chemical characterisation of individual particles at the tracheal and bronchial mucosas, and the accumulation of toxic elements in lung alveoli and lymph nodes. The particles and tissue elemental distributions were identified and characterised using micro-PIXE elemental mapping of thin frozen sections using the ITN Nuclear Microprobe facility. Significant particle deposits are found at the distal respiratory tract. Al, Si, Ti, V, Cr, Fe, Ni, Cu and Zn are elements detected at these accumulation areas. The elemental distributions in the different cellular environments of lymph nodes vary. The major compartments for Al, Si, Ti, Fe and Cr are the phagocytic cells and capsule of lymph nodes, while V and Ni are in the cortex and paracortex medullar areas which retain more than 70% of these two elements, suggesting high solubility of the latter in the cellular milieu. The elemental mobilisation from particles or deposits to surrounding tissues at the respiratory ducts evidences patterns of diffusion and removal that are different than those for elements in the respiratory tract. Mobilisation of elements such as V, Cr and Ni is more relevant at alveoli areas where gaseous exchange takes place. The apparent high solubility of V and Ni in the respiratory tract tissue points towards a deviation of the lymphatic system filtering efficiency for these elements when compared to others

Digital anthropomorphic phantoms of non-rigid human respiratory and voluntary body motion for investigating motion correction in emission imaging

International Nuclear Information System (INIS)

Könik, Arda; Johnson, Karen L; Dasari, Paul; Pretorius, P H; Dey, Joyoni; King, Michael A; Connolly, Caitlin M; Segars, Paul W; Lindsay, Clifford

2014-01-01

The development of methods for correcting patient motion in emission tomography has been receiving increased attention. Often the performance of these methods is evaluated through simulations using digital anthropomorphic phantoms, such as the commonly used extended cardiac torso (XCAT) phantom, which models both respiratory and cardiac motion based on human studies. However, non-rigid body motion, which is frequently seen in clinical studies, is not present in the standard XCAT phantom. In addition, respiratory motion in the standard phantom is limited to a single generic trend. In this work, to obtain a more realistic representation of motion, we developed a series of individual-specific XCAT phantoms, modeling non-rigid respiratory and non-rigid body motions derived from the magnetic resonance imaging (MRI) acquisitions of volunteers. Acquisitions were performed in the sagittal orientation using the Navigator methodology. Baseline (no motion) acquisitions at end-expiration were obtained at the beginning of each imaging session for each volunteer. For the body motion studies, MRI was again acquired only at end-expiration for five body motion poses (shoulder stretch, shoulder twist, lateral bend, side roll, and axial slide). For the respiratory motion studies, an MRI was acquired during free/regular breathing. The magnetic resonance slices were then retrospectively sorted into 14 amplitude-binned respiratory states, end-expiration, end-inspiration, six intermediary states during inspiration, and six during expiration using the recorded Navigator signal. XCAT phantoms were then generated based on these MRI data by interactive alignment of the organ contours of the XCAT with the MRI slices using a graphical user interface. Thus far we have created five body motion and five respiratory motion XCAT phantoms from the MRI acquisitions of six healthy volunteers (three males and three females). Non-rigid motion exhibited by the volunteers was reflected in both respiratory

Digital anthropomorphic phantoms of non-rigid human respiratory and voluntary body motion for investigating motion correction in emission imaging

Science.gov (United States)

Könik, Arda; Connolly, Caitlin M.; Johnson, Karen L.; Dasari, Paul; Segars, Paul W.; Pretorius, P. H.; Lindsay, Clifford; Dey, Joyoni; King, Michael A.

2014-07-01

The development of methods for correcting patient motion in emission tomography has been receiving increased attention. Often the performance of these methods is evaluated through simulations using digital anthropomorphic phantoms, such as the commonly used extended cardiac torso (XCAT) phantom, which models both respiratory and cardiac motion based on human studies. However, non-rigid body motion, which is frequently seen in clinical studies, is not present in the standard XCAT phantom. In addition, respiratory motion in the standard phantom is limited to a single generic trend. In this work, to obtain a more realistic representation of motion, we developed a series of individual-specific XCAT phantoms, modeling non-rigid respiratory and non-rigid body motions derived from the magnetic resonance imaging (MRI) acquisitions of volunteers. Acquisitions were performed in the sagittal orientation using the Navigator methodology. Baseline (no motion) acquisitions at end-expiration were obtained at the beginning of each imaging session for each volunteer. For the body motion studies, MRI was again acquired only at end-expiration for five body motion poses (shoulder stretch, shoulder twist, lateral bend, side roll, and axial slide). For the respiratory motion studies, an MRI was acquired during free/regular breathing. The magnetic resonance slices were then retrospectively sorted into 14 amplitude-binned respiratory states, end-expiration, end-inspiration, six intermediary states during inspiration, and six during expiration using the recorded Navigator signal. XCAT phantoms were then generated based on these MRI data by interactive alignment of the organ contours of the XCAT with the MRI slices using a graphical user interface. Thus far we have created five body motion and five respiratory motion XCAT phantoms from the MRI acquisitions of six healthy volunteers (three males and three females). Non-rigid motion exhibited by the volunteers was reflected in both respiratory

Contraindications to Athletic Participation. Cardiac, Respiratory, and Central Nervous System Conditions.

Science.gov (United States)

Moeller, James L.

1996-01-01

Discusses contraindications to athletic participation, examining the cardiac, respiratory, and central nervous system conditions that warrant activity disqualification. Provides guidelines about when it is safe for individuals to participate, and discusses the physician's responsibility. (SM)

Data on respiratory variables in critically ill patients with acute respiratory failure placed on proportional assist ventilation with load adjustable gain factors (PAV+

Directory of Open Access Journals (Sweden)

Dimitris Georgopoulos

2016-09-01

Full Text Available The data show respiratory variables in 108 critically ill patients with acute respiratory failure placed on proportional assist ventilation with load adjustable gain factors (PAV+ after at least 36 h on passive mechanical ventilation. PAV+ was continued for 48 h until the patients met pre-defined criteria either for switching to controlled modes or for breathing without ventilator assistance. Data during passive mechanical ventilation and during PAV+ are reported. Data are acquired from the whole population, as well as from patients with and without acute respiratory distress syndrome. The reported variables are tidal volume, driving pressure (ΔP, the difference between static end-inspiratory plateau pressure and positive end-expiratory airway pressure, respiratory system compliance and resistance, and arterial blood gasses. The data are supplemental to our original research article, which described individual ΔP in these patients and examined how it related to ΔP when the same patients were ventilated with passive mechanical ventilation using the currently accepted lung-protective strategy “Driving pressure during assisted mechanical ventilation. Is it controlled by patient brain?” [1]. Keywords: Tidal volume, Compliance, Driving pressure

Respiratory virus laboratory pandemic planning and surveillance in central Viet Nam, 2008-2010.

Science.gov (United States)

Tran, Thomas; Chien, Bui Trong; Papadakis, Georgina; Druce, Julian; Birch, Chris; Chibo, Doris; An, Truong Phuoc; Trang, Le Thi Kim; Trieu, Nguyen Bao; Thuy, Doan Thi Thanh; Catton, Mike; Mai, Trinh Xuan

2012-07-01

Laboratory capacity is needed in central Viet Nam to provide early warning to public health authorities of respiratory outbreaks of importance to human health, for example the outbreak of influenza A(H1N1) pandemic in 2009. Polymerase chain reaction (PCR) procedures established as part of a capacity-building process were used to conduct prospective respiratory surveillance in a region where few previous studies have been undertaken. Between October 2008 and September 2010, nose and throat swabs from adults and children (approximately 20 per week) presenting with an acute respiratory illness to the Ninh Hoa General Hospital were collected. Same-day PCR testing and result reporting for 13 respiratory viruses were carried out by locally trained scientists. Of 2144 surveillance samples tested, 1235 (57.6%) were positive for at least one virus. The most common were influenza A strains (17.9%), with pandemic influenza A(H1N1) 2009 and seasonal H3N2 strain accounting for 52% and 43% of these, respectively. Other virus detections included: rhinovirus (12.4%), enterovirus (8.9%), influenza B (8.3%), adenovirus (5.3%), parainfluenza (4.7%), respiratory syncytial virus (RSV) (3.9%), human coronavirus (3.0%) and human metapneumovirus (0.3%). The detection rate was greatest in the 0-5 year age group. Viral co-infections were identified in 148 (6.9%) cases. The outbreak in 2009 of the influenza A(H1N1) pandemic strain provided a practical test of the laboratory's pandemic plan. This study shows that the availability of appropriate equipment and molecular-based testing can contribute to important individual and public health outcomes in geographical locations susceptible to emerging infections.

Respiratory health status is impaired in UK HIV-positive adults with virologically suppressed HIV infection.

Science.gov (United States)

Brown, J; McGowan, J A; Chouial, H; Capocci, S; Smith, C; Ivens, D; Johnson, M; Sathia, L; Shah, R; Lampe, F C; Rodger, A; Lipman, M

2017-09-01

We sought to evaluate whether people living with HIV (PLWH) using effective antiretroviral therapy (ART) have worse respiratory health status than similar HIV-negative individuals. We recruited 197 HIV-positive and 93 HIV-negative adults from HIV and sexual health clinics. They completed a questionnaire regarding risk factors for respiratory illness. Respiratory health status was assessed using the St George's Respiratory Questionnaire (SGRQ) and the Medical Research Council (MRC) breathlessness scale. Subjects underwent spirometry without bronchodilation. PLWH had worse respiratory health status: the median SGRQ Total score was 12 [interquartile range (IQR) 6-25] in HIV-positive subjects vs. 6 (IQR 2-14) in HIV-negative subjects (P respiratory health appears more common in HIV-positive adults, and has a significant impact on health-related quality of life. © 2017 The Authors HIV Medicine published by John Wiley & Sons Ltd on behalf of British HIV Association.

Clinical definition of respiratory viral infections in young children and potential bronchiolitis misclassification.

Science.gov (United States)

Megalaa, Rosemary; Perez, Geovanny F; Kilaikode-Cheruveettara, Sasikumar; Kotwal, Nidhi; Rodriguez-Martinez, Carlos E; Nino, Gustavo

2018-01-01

Viral respiratory infections are often grouped as a single respiratory syndrome named 'viral bronchiolitis', independently of the viral etiology or individual risk factors. Clinical trials and guidelines have used a more stringent definition of viral bronchiolitis, including only the first episode of wheezing in children less than 12 months of age without concomitant respiratory comorbidities. There is increasing evidence suggesting that this definition is not being followed by pediatric care providers, but it is unclear to what extent viral respiratory infections are currently misclassified as viral bronchiolitis using standard definitions. We conducted a retrospective analysis of hospitalized young children (≤3 years) due to viral respiratory infections. Bronchiolitis was defined as the first wheezing episode less than 12 months of age. Demographic variables and comorbidities were obtained by electronic medical record review. The study comprised a total of 513 hospitalizations (n=453). Viral bronchiolitis was diagnosed in 144 admissions (28.1%). Notably, we identified that the majority of children diagnosed with bronchiolitis (63%) were misclassified as they had prior episodes of wheezing. Many children with bronchiolitis misclassification had significant comorbidities, including prematurity (51%), neuromuscular conditions (9.8%), and congenital heart disease (9.8%). Misclassification of bronchiolitis is a common problem that may lead to inappropriate management of viral respiratory infections in young children. A comprehensive approach that takes into consideration viral etiology and individual risk factors may lead to a more accurate clinical assessment of this condition and would potentially prevent bronchiolitis misclassification. © American Federation for Medical Research (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Respiratory allergen from house dust mite is present in human milk and primes for allergic sensitization in a mouse model of asthma.

Science.gov (United States)

Macchiaverni, P; Rekima, A; Turfkruyer, M; Mascarell, L; Airouche, S; Moingeon, P; Adel-Patient, K; Condino-Neto, A; Annesi-Maesano, I; Prescott, S L; Tulic, M K; Verhasselt, V

2014-03-01

There is an urgent need to identify environmental risk and protective factors in early life for the prevention of allergy. Our study demonstrates the presence of respiratory allergen from house dust mite, Der p 1, in human breast milk. Der p 1 in milk is immunoreactive, present in similar amounts as dietary egg antigen, and can be found in breast milk from diverse regions of the world. In a mouse model of asthma, oral exposure to Der p through breast milk strongly promotes sensitization rather than protect the progeny as we reported with egg antigen. These data highlight that antigen administration to the neonate through the oral route may contribute to child allergic sensitization and have important implications for the design of studies assessing early oral antigen exposure for allergic disease prevention. The up-to-now unknown worldwide presence of respiratory allergen in maternal milk allows new interpretation and design of environmental control epidemiological studies for allergic disease prevention. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Sexuality of the elder individual presented on paintings

Directory of Open Access Journals (Sweden)

Josiane Aparecida Duarte

2013-12-01

Full Text Available The sexuality of the elder has a history of negligence, seen as a taboo, both by society and by the individual himself, contributing to maintain the oppressive cultural standards related to the theme of sexuality related to aging. In the great majority of paintings, the elder individual is presented as an asexual character. The representation of the elder in paintings is usually shown in the following contexts: domestic (“St Joseph, The carpenter” – George de La Tour, 1642; “The Paralytic” – Jean Baptiste Greuze, 1763 and in the decadence of health (“Old man in sorrow” – Van Gogh, 1890; “The old guitarist” – Picasso, 1903. On the few paintings that retract the sexuality of the elder, we can see a clear prominence of the male gender (“Susana and the elders” – Artemisia Gentileschi, 1610; “Elderly nude in the sun” – Mariano Fortuny, 1871. Sexuality of the elder woman is little referred to, being predominantly portrayed in her domestic role. When sexuality is shown it is in the context of prostitution, as in the work “The Salon I”, of Otto Dix, 1921. Between painters of the 20th century, there are self portraits in which artists of both genders paint themselves naked in advanced age, showing a tendency in changing the current paradigm: “Painter working, Reflection” – Lucian Freud, 1993 that portrayed himself at the age of 70; and “Self Portrait” – Alice Neel, 1980, at the age of 80.

Indigenous Respiratory Outreach Care: the first 18 months of a specialist respiratory outreach service to rural and remote Indigenous communities in Queensland, Australia.

Science.gov (United States)

Medlin, Linda G; Chang, Anne B; Fong, Kwun; Jackson, Rebecca; Bishop, Penny; Dent, Annette; Hill, Deb C; Vincent, Stephen; O'Grady, Kerry-Ann F

2014-09-01

Respiratory diseases are a leading cause of morbidity and mortality in Indigenous Australians. However, there are limited approaches to specialist respiratory care in rural and remote communities that are culturally appropriate. A specialist Indigenous Respiratory Outreach Care (IROC) program, developed to address this gap, is described. The aim of the present study was to implement, pilot and evaluate multidisciplinary specialist respiratory outreach medical teams in rural and remote Indigenous communities in Queensland, Australia. Sites were identified based on a perception of unmet need, burden of respiratory disease and/or capacity to use the clinical service and capacity building for support offered. IROC commenced in March 2011 and, to date, has been implemented in 13 communities servicing a population of approximately 43000 Indigenous people. Clinical service delivery has been possible through community engagement and capacity building initiatives directed by community protocols. IROC is a culturally sensitive and sustainable model for adult and paediatric specialist outreach respiratory services that may be transferrable to Indigenous communities across Queensland and Australia.

Transient hypoxic respiratory failure in a patient with severe hypophosphatemia.

Science.gov (United States)

Oud, Lavi

2009-03-01

Respiratory failure in severely hypophosphatemic patients has been attributed to respiratory muscle weakness, leading to ventilatory failure. While frequently documenting hypercarbic respiratory failure, previous reports of hypophosphatemia-related respiratory failure in patients otherwise free of pulmonary or airway disease often did not provide sufficient information on gas exchange and pulmonary function, precluding inference on alternative or additional sources of respiratory dysfunction in this population. We report a case of acute hypoxic respiratory failure in a 26 year-old bulimic woman with severe hypophosphatemia. The patient presented with acute onset of dyspnea, paresthesias, limb shaking, and severe hyperventilation. SpO2 was 74%, requiring administration of 100% O2, with normal chest radiograph. Serum phosphate was <0.3 mmol/liter (1.0 mg/dL). Further evaluation did not support pulmonary, vascular, neurogenic or external exposure-related causes of hypoxic respiratory failure, which rapidly resolved with parenteral correction of hypophosphatemia. To date, hypoxic respiratory failure has not been reported in association with hypophosphatemia. Increased awareness and further investigations can help elucidate the mechanisms of hypophosphatemia-associated hypoxemia.

Neonatal respiratory distress syndrome

Science.gov (United States)

Hyaline membrane disease (HMD); Infant respiratory distress syndrome; Respiratory distress syndrome in infants; RDS - infants ... improves slowly after that. Some infants with severe respiratory distress syndrome will die. This most often occurs ...

Activation of respiratory muscles during respiratory muscle training.

Science.gov (United States)

Walterspacher, Stephan; Pietsch, Fabian; Walker, David Johannes; Röcker, Kai; Kabitz, Hans-Joachim

2018-01-01

It is unknown which respiratory muscles are mainly activated by respiratory muscle training. This study evaluated Inspiratory Pressure Threshold Loading (IPTL), Inspiratory Flow Resistive Loading (IFRL) and Voluntary Isocapnic Hyperpnea (VIH) with regard to electromyographic (EMG) activation of the sternocleidomastoid muscle (SCM), parasternal muscles (PARA) and the diaphragm (DIA) in randomized order. Surface EMG were analyzed at the end of each training session and normalized using the peak EMG recorded during maximum inspiratory maneuvers (Sniff nasal pressure: SnPna, maximal inspiratory mouth occlusion pressure: PImax). 41 healthy participants were included. Maximal activation was achieved for SCM by SnPna; the PImax activated predominantly PARA and DIA. Activations of SCM and PARA were higher in IPTL and VIH than for IFRL (p<0.05). DIA was higher applying IPTL compared to IFRL or VIH (p<0.05). IPTL, IFRL and VIH differ in activation of inspiratory respiratory muscles. Whereas all methods mainly stimulate accessory respiratory muscles, diaphragm activation was predominant in IPTL. Copyright © 2017 Elsevier B.V. All rights reserved.

Air pollution and vulnerability of exposed individuals: the case of downtown Medellín

Directory of Open Access Journals (Sweden)

Gabriel J. González

2012-02-01

Full Text Available The presence of respiratory problems in high level pollution areas is linked to factors such as exposure, susceptibility, and social coping. Objective: To present statistical evidence regarding the relationship between the probability of experiencing symptoms or contracting a respiratory disease and factors such as exposure to pollution, susceptibility, and social coping among people inhabiting areas with particulate matter pollution. Methodology: The study used unique information collected from a survey conducted on 1000 people in downtown Medellin who were exposed to this problem. This information was used to perform a descriptive statistic analysis and to build 27 probit models. The dependent variables were: the patient has a symptom or disease –emf-, the patient has a symptom –leve-, and the patient has a respiratory disease –grave-. Results: The results evidence that exposure is a key variable affecting the presence of respiratory symptoms or diseases (vulnerability; however, exposed individuals may also experience health problems not only due to air pollution per se, but also to implicit personal and social conditions.

What Is Respiratory Distress Syndrome?

Science.gov (United States)

... Home / Respiratory Distress Syndrome Respiratory Distress Syndrome Also known as What Is Respiratory ... This condition is called apnea (AP-ne-ah). Respiratory Distress Syndrome Complications Depending on the severity of ...

To find the tree in the forest - radiological presentation of idiopathic interstitial pneumonias

International Nuclear Information System (INIS)

Kirova, G.; Stoeva, N.; Benova, A.; Penev, A.; Penev, B.

2009-01-01

Full text: Idiopathic Interstitial Pneumonias (IIP) are a large group of diffuse parenchymal lung diseases which have similar clinical and radiographic characteristics and at the same time they are completely different which separates them as a nosological units. The aim of this report is: to present the modern classification built on consensus between the Thoracal American Association and the European Respiratory Association; to illustrate the main CT characteristics in individual IIP and, where is possible, comparison with histopathological changes; to present the methodological approach in the process of differentiation of individual diseases in the group based on the individual X-ray characteristics, clinical presentation and expected prognosis. American Thoracic Association and the European Respiratory Association offer classes consensus classification of IIP, published in 2002, defining the morphological characteristics on the basis of which it is based and radiological-pathological diagnosis of IIP. Radiographic evaluation of the IIP is difficult because various changes can exist in a patient's lung, while the same nosological units can be represented with different X-ray picture depending on the gravity of his occurrence. Clinical evaluation is not a real diagnostic, but together with the conventional X-Ray findings, the functional study of respiration and CT image can give deferential diagnostics effect. The distinction between different IIP is particularly important due to the different prognosis, that each of these diseases carries. Authors stress on the importance of the interdisciplinary team for the correct final diagnosis, based on a correlation between clinical picture, imaging and histopathological findings

Severe acute respiratory syndrome (SARS)

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SARS; Respiratory failure - SARS ... Complications may include: Respiratory failure Liver failure Heart failure ... 366. McIntosh K, Perlman S. Coronaviruses, including severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS). ...

Unusual Respiratory Manifestations in Two Young Adults with Duchenne Muscular Dystrophy

Directory of Open Access Journals (Sweden)

Julie Lemay

2012-01-01

Full Text Available Adult respirologists are often involved in the evaluation and treatment of young adult patients with Duchenne muscular dystrophy. In this context, the most frequent respiratory complication is nocturnal and daytime hypoventilation related to respiratory muscle weakness. The present article describes cases of Duchenne muscular dystrophy involving two brothers, 17 and 19 years of age, respectively, who presented with less frequently reported respiratory complications of their disease: obstructive sleep apnea and Cheyne-Stokes respiration with central apnea, which were believed to be partially or completely related to congestive cardiomyopathy.

The role of the local microbial ecosystem in respiratory health and disease.

Science.gov (United States)

de Steenhuijsen Piters, Wouter A A; Sanders, Elisabeth A M; Bogaert, Debby

2015-08-19

Respiratory tract infections are a major global health concern, accounting for high morbidity and mortality, especially in young children and elderly individuals. Traditionally, highly common bacterial respiratory tract infections, including otitis media and pneumonia, were thought to be caused by a limited number of pathogens including Streptococcus pneumoniae and Haemophilus influenzae. However, these pathogens are also frequently observed commensal residents of the upper respiratory tract (URT) and form-together with harmless commensal bacteria, viruses and fungi-intricate ecological networks, collectively known as the 'microbiome'. Analogous to the gut microbiome, the respiratory microbiome at equilibrium is thought to be beneficial to the host by priming the immune system and providing colonization resistance, while an imbalanced ecosystem might predispose to bacterial overgrowth and development of respiratory infections. We postulate that specific ecological perturbations of the bacterial communities in the URT can occur in response to various lifestyle or environmental effectors, leading to diminished colonization resistance, loss of containment of newly acquired or resident pathogens, preluding bacterial overgrowth, ultimately resulting in local or systemic bacterial infections. Here, we review the current body of literature regarding niche-specific upper respiratory microbiota profiles within human hosts and the changes occurring within these profiles that are associated with respiratory infections. © 2015 The Author(s) Published by the Royal Society. All rights reserved.

Respiratory muscle training for cystic fibrosis.

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Hilton, Nathan; Solis-Moya, Arturo

2018-05-24

Cystic fibrosis is the most common autosomal recessive disease in white populations, and causes respiratory dysfunction in the majority of individuals. Numerous types of respiratory muscle training to improve respiratory function and health-related quality of life in people with cystic fibrosis have been reported in the literature. Hence a systematic review of the literature is needed to establish the effectiveness of respiratory muscle training (either inspiratory or expiratory muscle training) on clinical outcomes in cystic fibrosis. This is an update of a previously published review. To determine the effectiveness of respiratory muscle training on clinical outcomes in people with cystic fibrosis. We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Trials register comprising of references identified from comprehensive electronic database searches and handsearches of relevant journals and abstract books of conference proceedings.Date of most recent search: 17 April 2018.A hand search of the Journal of Cystic Fibrosis and Pediatric Pulmonology was performed, along with an electronic search of online trial databases up until 07 May 2018. Randomised controlled studies comparing respiratory muscle training with a control group in people with cystic fibrosis. Review authors independently selected articles for inclusion, evaluated the methodological quality of the studies, and extracted data. Additional information was sought from trial authors where necessary. The quality of the evidence was assessed using the GRADE system MAIN RESULTS: Authors identified 19 studies, of which nine studies with 202 participants met the review's inclusion criteria. There was wide variation in the methodological and written quality of the included studies. Four of the nine included studies were published as abstracts only and lacking concise details, thus limiting the information available. Seven studies were parallel studies and two of a cross-over design. Respiratory

Respiratory Changes in Response to Cognitive Load: A Systematic Review.

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Grassmann, Mariel; Vlemincx, Elke; von Leupoldt, Andreas; Mittelstädt, Justin M; Van den Bergh, Omer

2016-01-01

When people focus attention or carry out a demanding task, their breathing changes. But which parameters of respiration vary exactly and can respiration reliably be used as an index of cognitive load? These questions are addressed in the present systematic review of empirical studies investigating respiratory behavior in response to cognitive load. Most reviewed studies were restricted to time and volume parameters while less established, yet meaningful parameters such as respiratory variability have rarely been investigated. The available results show that respiratory behavior generally reflects cognitive processing and that distinct parameters differ in sensitivity: While mentally demanding episodes are clearly marked by faster breathing and higher minute ventilation, respiratory amplitude appears to remain rather stable. The present findings further indicate that total variability in respiratory rate is not systematically affected by cognitive load whereas the correlated fraction decreases. In addition, we found that cognitive load may lead to overbreathing as indicated by decreased end-tidal CO2 but is also accompanied by elevated oxygen consumption and CO2 release. However, additional research is needed to validate the findings on respiratory variability and gas exchange measures. We conclude by outlining recommendations for future research to increase the current understanding of respiration under cognitive load.

Respiratory gating in cardiac PET

DEFF Research Database (Denmark)

Lassen, Martin Lyngby; Rasmussen, Thomas; Christensen, Thomas E

2017-01-01

BACKGROUND: Respiratory motion due to breathing during cardiac positron emission tomography (PET) results in spatial blurring and erroneous tracer quantification. Respiratory gating might represent a solution by dividing the PET coincidence dataset into smaller respiratory phase subsets. The aim...... of our study was to compare the resulting imaging quality by the use of a time-based respiratory gating system in two groups administered either adenosine or dipyridamole as the pharmacological stress agent. METHODS AND RESULTS: Forty-eight patients were randomized to adenosine or dipyridamole cardiac...... stress (82)RB-PET. Respiratory rates and depths were measured by a respiratory gating system in addition to registering actual respiratory rates. Patients undergoing adenosine stress showed a decrease in measured respiratory rate from initial to later scan phase measurements [12.4 (±5.7) vs 5.6 (±4...

The Clinical Utilisation of Respiratory Elastance Software (CURE Soft): a bedside software for real-time respiratory mechanics monitoring and mechanical ventilation management.

Science.gov (United States)

Szlavecz, Akos; Chiew, Yeong Shiong; Redmond, Daniel; Beatson, Alex; Glassenbury, Daniel; Corbett, Simon; Major, Vincent; Pretty, Christopher; Shaw, Geoffrey M; Benyo, Balazs; Desaive, Thomas; Chase, J Geoffrey

2014-09-30

Real-time patient respiratory mechanics estimation can be used to guide mechanical ventilation settings, particularly, positive end-expiratory pressure (PEEP). This work presents a software, Clinical Utilisation of Respiratory Elastance (CURE Soft), using a time-varying respiratory elastance model to offer this ability to aid in mechanical ventilation treatment. CURE Soft is a desktop application developed in JAVA. It has two modes of operation, 1) Online real-time monitoring decision support and, 2) Offline for user education purposes, auditing, or reviewing patient care. The CURE Soft has been tested in mechanically ventilated patients with respiratory failure. The clinical protocol, software testing and use of the data were approved by the New Zealand Southern Regional Ethics Committee. Using CURE Soft, patient's respiratory mechanics response to treatment and clinical protocol were monitored. Results showed that the patient's respiratory elastance (Stiffness) changed with the use of muscle relaxants, and responded differently to ventilator settings. This information can be used to guide mechanical ventilation therapy and titrate optimal ventilator PEEP. CURE Soft enables real-time calculation of model-based respiratory mechanics for mechanically ventilated patients. Results showed that the system is able to provide detailed, previously unavailable information on patient-specific respiratory mechanics and response to therapy in real-time. The additional insight available to clinicians provides the potential for improved decision-making, and thus improved patient care and outcomes.

Respiratory and metabolic acidosis differentially affect the respiratory neuronal network in the ventral medulla of neonatal rats.

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Okada, Yasumasa; Masumiya, Haruko; Tamura, Yoshiyasu; Oku, Yoshitaka

2007-11-01

Two respiratory-related areas, the para-facial respiratory group/retrotrapezoid nucleus (pFRG/RTN) and the pre-Bötzinger complex/ventral respiratory group (preBötC/VRG), are thought to play key roles in respiratory rhythm. Because respiratory output patterns in response to respiratory and metabolic acidosis differ, we hypothesized that the responses of the medullary respiratory neuronal network to respiratory and metabolic acidosis are different. To test these hypotheses, we analysed respiratory-related activity in the pFRG/RTN and preBötC/VRG of the neonatal rat brainstem-spinal cord in vitro by optical imaging using a voltage-sensitive dye, and compared the effects of respiratory and metabolic acidosis on these two populations. We found that the spatiotemporal responses of respiratory-related regional activities to respiratory and metabolic acidosis are fundamentally different, although both acidosis similarly augmented respiratory output by increasing respiratory frequency. PreBötC/VRG activity, which is mainly inspiratory, was augmented by respiratory acidosis. Respiratory-modulated pixels increased in the preBötC/VRG area in response to respiratory acidosis. Metabolic acidosis shifted the respiratory phase in the pFRG/RTN; the pre-inspiratory dominant pattern shifted to inspiratory dominant. The responses of the pFRG/RTN activity to respiratory and metabolic acidosis are complex, and involve either augmentation or reduction in the size of respiratory-related areas. Furthermore, the activation pattern in the pFRG/RTN switched bi-directionally between pre-inspiratory/inspiratory and post-inspiratory. Electrophysiological study supported the results of our optical imaging study. We conclude that respiratory and metabolic acidosis differentially affect activities of the pFRG/RTN and preBötC/VRG, inducing switching and shifts of the respiratory phase. We suggest that they differently influence the coupling states between the pFRG/RTN and preBötC/VRG.

Lungs and Respiratory System

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... Videos for Educators Search English Español Lungs and Respiratory System KidsHealth / For Parents / Lungs and Respiratory System ... ll have taken at least 600 million breaths. Respiratory System Basics All of this breathing couldn't ...

Evaluation of exercise-respiratory system modifications and integration schemes for physiological systems

Science.gov (United States)

Gallagher, R. R.

1974-01-01

Exercise subroutine modifications are implemented in an exercise-respiratory system model yielding improvement of system response to exercise forcings. A more physiologically desirable respiratory ventilation rate in addition to an improved regulation of arterial gas tensions and cerebral blood flow is observed. A respiratory frequency expression is proposed which would be appropriate as an interfacing element of the respiratory-pulsatile cardiovascular system. Presentation of a circulatory-respiratory system integration scheme along with its computer program listing is given. The integrated system responds to exercise stimulation for both nonstressed and stressed physiological states. Other integration possibilities are discussed with respect to the respiratory, pulsatile cardiovascular, thermoregulatory, and the long-term circulatory systems.

Needles in the haystack: identifying individuals present in pooled genomic data.

Directory of Open Access Journals (Sweden)

Rosemary Braun

2009-10-01

Full Text Available Recent publications have described and applied a novel metric that quantifies the genetic distance of an individual with respect to two population samples, and have suggested that the metric makes it possible to infer the presence of an individual of known genotype in a sample for which only the marginal allele frequencies are known. However, the assumptions, limitations, and utility of this metric remained incompletely characterized. Here we present empirical tests of the method using publicly accessible genotypes, as well as analytical investigations of the method's strengths and limitations. The results reveal that the null distribution is sensitive to the underlying assumptions, making it difficult to accurately calibrate thresholds for classifying an individual as a member of the population samples. As a result, the false-positive rates obtained in practice are considerably higher than previously believed. However, despite the metric's inadequacies for identifying the presence of an individual in a sample, our results suggest potential avenues for future research on tuning this method to problems of ancestry inference or disease prediction. By revealing both the strengths and limitations of the proposed method, we hope to elucidate situations in which this distance metric may be used in an appropriate manner. We also discuss the implications of our findings in forensics applications and in the protection of GWAS participant privacy.

Longitudinal study of respiratory function and symptoms in a non-smoking group of long-term officially-acknowledged victims of pollution-related illness.

Science.gov (United States)

Tanaka, Takako; Asai, Masaharu; Yanagita, Yorihide; Nishinakagawa, Tsuyoshi; Miyamoto, Naomi; Kotaki, Kenji; Yano, Yudai; Kozu, Ryo; Honda, Sumihisa; Senjyu, Hideaki

2013-08-17

Air pollution is known to be a leading cause of respiratory symptoms. Many cross-sectional studies reported that air pollution caused respiratory disease in Japanese individuals in the 1960s. Japan has laws regulating air pollution levels and providing compensation for victims of pollution-related respiratory disease. However, long-term changes in respiratory function and symptoms in individuals who were exposed to air pollution in the 1960s have not been well studied. This study aimed to investigate longitudinal respiratory function and symptoms in older, non-smoking, long-term officially-acknowledged victims of pollution-related illness. The study included 563 officially-acknowledged victims of pollution-related illness living in Kurashiki, Okayama who were aged ≥ 65 years in 2009. Data were retrospectively collected from yearly respiratory symptom questionnaires and spirometry examinations conducted from 2000 to 2009. Respiratory function declined significantly from 2000 to 2009 (p pollutants around 1970 resulted in a decrease in respiratory function and an increase in respiratory symptoms in the study population. From 2000 to 2009, the mean annual changes in respiratory function were within the normal range, even though the severity of dyspnea worsened. The changes in respiratory function and symptoms over the study period were probably due to aging. The laws governing air pollution levels and providing compensation for officially-acknowledged victims of pollution-related illness in Japan may be effective for respiratory disease cause by pollution.

Effect of transoral tracheal wash on respiratory mechanics in dogs with respiratory disease.

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Vaught, Meghan E; Rozanski, Elizabeth A; deLaforcade, Armelle M

2018-01-01

The purpose of this study was to determine the impact of a transoral tracheal wash (TOTW) on respiratory mechanics in dogs and to describe the use of a critical care ventilator (CCV) to determine respiratory mechanics. Fourteen client-owned dogs with respiratory diseases were enrolled. Respiratory mechanics, including static compliance (C stat ) and static resistance (R stat ), were determined before and after TOTW. Pre- and post-wash results were compared, with a P -value of mechanics, as observed by a reduction in C stat , presumably due to airway flooding and collapse. While no long-lasting effects were noted in these clinical patients, this effect should be considered when performing TOTW on dogs with respiratory diseases. Respiratory mechanics testing using a CCV was feasible and may be a useful clinical testing approach.

Respiratory muscle function and exercise limitation in patients with chronic obstructive pulmonary disease: a review.

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Charususin, Noppawan; Dacha, Sauwaluk; Gosselink, Rik; Decramer, Marc; Von Leupoldt, Andreas; Reijnders, Thomas; Louvaris, Zafeiris; Langer, Daniel

2018-01-01

Respiratory muscle dysfunction is common and contributes to dyspnea and exercise limitation in patients with chronic obstructive pulmonary disease (COPD). Improving dynamic function of respiratory muscles during exercise might help to reduce symptoms and improve exercise capacity. Areas covered: The aims of this review are to 1) summarize physiological mechanisms linking respiratory muscle dysfunction to dyspnea and exercise limitation; 2) provide an overview of available therapeutic approaches to better maintain load-capacity balance of respiratory muscles during exercise; and 3) to summarize current knowledge on potential mechanisms explaining effects of interventions aimed at optimizing dynamic respiratory muscle function with a special focus on inspiratory muscle training. Expert commentary: Several mechanisms which are potentially linking improvements in dynamic respiratory muscle function to symptomatic and functional benefits have not been studied so far in COPD patients. Examples of underexplored areas include the study of neural processes related to the relief of acute dyspnea and the competition between respiratory and peripheral muscles for limited energy supplies during exercise. Novel methodologies are available to non-invasively study these mechanisms. Better insights into the consequences of dynamic respiratory muscle dysfunction will hopefully contribute to further refine and individualize therapeutic approaches in patients with COPD.

Six months of dance intervention enhances postural, sensorimotor, and cognitive performance in elderly without affecting cardio-respiratory functions

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Kattenstroth, Jan-Christoph; Kalisch, Tobias; Holt, Stephan; Tegenthoff, Martin; Dinse, Hubert R.

2013-01-01

During aging, sensorimotor, cognitive and physical performance decline, but can improve by training and exercise indicating that age-related changes are treatable. Dancing is increasingly used as an intervention because it combines many diverse features making it a promising neuroplasticity-inducing tool. We here investigated the effects of a 6-month dance class (1 h/week) on a group of healthy elderly individuals compared to a matched control group (CG). We performed a broad assessment covering cognition, intelligence, attention, reaction time, motor, tactile, and postural performance, as well as subjective well-being and cardio-respiratory performance. After 6 months, in the CG no changes, or further degradation of performance was found. In the dance group, beneficial effects were found for dance-related parameters such as posture and reaction times, but also for cognitive, tactile, motor performance, and subjective well-being. These effects developed without alterations in the cardio-respiratory performance. Correlation of baseline performance with the improvement following intervention revealed that those individuals, who benefitted most from the intervention, were those who showed the lowest performance prior to the intervention. Our findings corroborate previous observations that dancing evokes widespread positive effects. The pre-post design used in the present study implies that the efficacy of dance is most likely not based on a selection bias of particularly gifted individuals. The lack of changes of cardio-respiratory fitness indicates that even moderate levels of physical activity can in combination with rich sensorimotor, cognitive, social, and emotional challenges act to ameliorate a wide spectrum of age-related decline. PMID:23447455

Six months of dance intervention enhances postural, sensorimotor, and cognitive performance in elderly without affecting cardio-respiratory functions

Directory of Open Access Journals (Sweden)

Jan-Christoph eKattenstroth

2013-02-01

Full Text Available During aging, sensorimotor, cognitive and physical performance decline, but can improve by training and exercise indicating that age-related changes are treatable. Dancing is increasingly used as an intervention because it combines many diverse features making it a promising neuroplasticity-inducing tool. We here investigated the effects of a 6-months dance class (1 h/week on a group of healthy elderly individuals compared to a matched control group. We performed a broad assessment covering cognition, intelligence, attention, reaction time, motor, tactile, and postural performance, as well as subjective well-being and cardio-respiratory performance. After 6 months, in the control group no changes, or further degradation of performance was found. In the dance group, beneficial effects were found for dance-related parameters such as posture and reaction times, but also for cognitive, tactile, motor performance, and subjective well-being. These effects developed without alterations in the cardio-respiratory performance. Correlation of baseline performance with the improvement following intervention revealed that those individuals, who benefitted most from the intervention, were those who showed the lowest performance prior to the intervention. Our findings corroborate previous observations that dancing evokes widespread positive effects. The pre-post design used in the present study implies that the efficacy of dance is most likely not based on a selection bias of particularly gifted individuals. The lack of changes of cardio-respiratory fitness indicates that even moderate levels of physical activity can in combination with rich sensorimotor, cognitive, social, and emotional challenges act to ameliorate a wide spectrum of age-related decline.

Transmission of human respiratory syncytial virus in the immunocompromised ferret model

NARCIS (Netherlands)

de Waal, L. (Leon); S.L. Smits (Saskia); E.J.B. Veldhuis Kroeze (Edwin); G. van Amerongen (Geert); Pohl, M.O. (Marie O.); Osterhaus, A.D.M.E. (Albert D. M. E.); K.J. Stittelaar (Koert)

2018-01-01

textabstractHuman respiratory syncytial virus (HRSV) causes substantial morbidity and mortality in vulnerable patients, such as the very young, the elderly, and immunocompromised individuals of any age. Nosocomial transmission of HRSV remains a serious challenge in hospital settings, with

Increased release of histamine in patients with respiratory symptoms related to perfume

DEFF Research Database (Denmark)

Elberling, J; Skov, P S; Mosbech, H

2007-01-01

BACKGROUND: Environmental perfume exposure may cause respiratory symptoms. Individuals with asthma and perfume contact allergy report such symptoms more frequently than others. However, immunologic mechanisms have not been demonstrated and the symptoms are not associated with IgE-mediated allergy....... The study aimed to investigate whether basophils from patients with respiratory symptoms related to perfume released more histamine in the presence of perfume as compared with healthy volunteers. METHODS: Histamine release was measured by the glass fibre method. Blood was obtained from healthy volunteers (n......=20) and patients with respiratory symptoms related to perfume (n=17) attending a dermatological outpatient clinic for patch testing. The effect of an international brand perfume was investigated using the basophil histamine release test with perfume. Furthermore, basophils from a healthy non...

Respiratory mechanics and fluid dynamics after lung resection surgery.

Science.gov (United States)

Miserocchi, Giuseppe; Beretta, Egidio; Rivolta, Ilaria

2010-08-01

Thoracic surgery that requires resection of a portion of lung or of a whole lung profoundly alters the mechanical and fluid dynamic setting of the lung-chest wall coupling, as well as the water balance in the pleural space and in the remaining lung. The most frequent postoperative complications are of a respiratory nature, and their incidence increases the more the preoperative respiratory condition seems compromised. There is an obvious need to identify risk factors concerning mainly the respiratory function, without neglecting the importance of other comorbidities, such as coronary disease. At present, however, a satisfactory predictor of postoperative cardiopulmonary complications is lacking; postoperative morbidity and mortality have remained unchanged in the last 10 years. The aim of this review is to provide a pathophysiologic interpretation of the main respiratory complications of a respiratory nature by relying on new concepts relating to lung fluid dynamics and mechanics. New parameters are proposed to improve evaluation of respiratory function from pre- to the early postoperative period when most of the complications occur. Published by Elsevier Inc.

Model-based setting of inspiratory pressure and respiratory rate in pressure-controlled ventilation

International Nuclear Information System (INIS)

Schranz, C; Möller, K; Becher, T; Schädler, D; Weiler, N

2014-01-01

Mechanical ventilation carries the risk of ventilator-induced-lung-injury (VILI). To minimize the risk of VILI, ventilator settings should be adapted to the individual patient properties. Mathematical models of respiratory mechanics are able to capture the individual physiological condition and can be used to derive personalized ventilator settings. This paper presents model-based calculations of inspiration pressure (p I ), inspiration and expiration time (t I , t E ) in pressure-controlled ventilation (PCV) and a retrospective evaluation of its results in a group of mechanically ventilated patients. Incorporating the identified first order model of respiratory mechanics in the basic equation of alveolar ventilation yielded a nonlinear relation between ventilation parameters during PCV. Given this patient-specific relation, optimized settings in terms of minimal p I and adequate t E can be obtained. We then retrospectively analyzed data from 16 ICU patients with mixed pathologies, whose ventilation had been previously optimized by ICU physicians with the goal of minimization of inspiration pressure, and compared the algorithm's ‘optimized’ settings to the settings that had been chosen by the physicians. The presented algorithm visualizes the patient-specific relations between inspiration pressure and inspiration time. The algorithm's calculated results highly correlate to the physician's ventilation settings with r = 0.975 for the inspiration pressure, and r = 0.902 for the inspiration time. The nonlinear patient-specific relations of ventilation parameters become transparent and support the determination of individualized ventilator settings according to therapeutic goals. Thus, the algorithm is feasible for a variety of ventilated ICU patients and has the potential of improving lung-protective ventilation by minimizing inspiratory pressures and by helping to avoid the build-up of clinically significant intrinsic positive end

Model-based setting of inspiratory pressure and respiratory rate in pressure-controlled ventilation.

Science.gov (United States)

Schranz, C; Becher, T; Schädler, D; Weiler, N; Möller, K

2014-03-01

Mechanical ventilation carries the risk of ventilator-induced-lung-injury (VILI). To minimize the risk of VILI, ventilator settings should be adapted to the individual patient properties. Mathematical models of respiratory mechanics are able to capture the individual physiological condition and can be used to derive personalized ventilator settings. This paper presents model-based calculations of inspiration pressure (pI), inspiration and expiration time (tI, tE) in pressure-controlled ventilation (PCV) and a retrospective evaluation of its results in a group of mechanically ventilated patients. Incorporating the identified first order model of respiratory mechanics in the basic equation of alveolar ventilation yielded a nonlinear relation between ventilation parameters during PCV. Given this patient-specific relation, optimized settings in terms of minimal pI and adequate tE can be obtained. We then retrospectively analyzed data from 16 ICU patients with mixed pathologies, whose ventilation had been previously optimized by ICU physicians with the goal of minimization of inspiration pressure, and compared the algorithm's 'optimized' settings to the settings that had been chosen by the physicians. The presented algorithm visualizes the patient-specific relations between inspiration pressure and inspiration time. The algorithm's calculated results highly correlate to the physician's ventilation settings with r = 0.975 for the inspiration pressure, and r = 0.902 for the inspiration time. The nonlinear patient-specific relations of ventilation parameters become transparent and support the determination of individualized ventilator settings according to therapeutic goals. Thus, the algorithm is feasible for a variety of ventilated ICU patients and has the potential of improving lung-protective ventilation by minimizing inspiratory pressures and by helping to avoid the build-up of clinically significant intrinsic positive end-expiratory pressure.

Sudden death of a child due to respiratory diphtheria.

Science.gov (United States)

Swain, Rajanikanta; Behera, Chittaranjan; Arava, Sudheer Kumar; Kundu, Naveen

2016-06-01

A four-year-old girl presented to the emergency department with respiratory distress. Death occurred despite attempted resuscitation. The illness was not clinically diagnosed. Her father revealed that she had a fever and sore throat for the last four days and was not immunised for diphtheria. Characteristic gross and microscopic pathology of respiratory diphtheria and microbiological findings were observed. The cause of death was acute respiratory failure consequent upon upper airway obstruction from diphtheria. Forensic pathologists should remember that the diphtheria cases can cause sudden death especially in developing countries. © The Author(s) 2016.

Climate Change Effects on Respiratory Health: Implications for Nursing.

Science.gov (United States)

George, Maureen; Bruzzese, Jean-Marie; Matura, Lea Ann

2017-11-01

Greenhouse gases are driving climate change. This article explores the adverse health effects of climate change on a particularly vulnerable population: children and adults with respiratory conditions. This review provides a general overview of the effects of increasing temperatures, extreme weather, desertification, and flooding on asthma, chronic obstructive lung disease, and respiratory infections. We offer suggestions for future research to better understand climate change hazards, policies to support prevention and mitigation efforts targeting climate change, and clinical actions to reduce individual risk. Climate change produces a number of changes to the natural and built environments that may potentially increase respiratory disease prevalence, morbidity, and mortality. Nurses might consider focusing their research efforts on reducing the effects of greenhouse gases and in directing policy to mitigate the harmful effects of climate change. Nurses can also continue to direct educational and clinical actions to reduce risks for all populations, but most importantly, for our most vulnerable groups. While advancements have been made in understanding the impact of climate change on respiratory health, nurses can play an important role in reducing the deleterious effects of climate change. This will require a multipronged approach of research, policy, and clinical action. © 2017 Sigma Theta Tau International.

The respiratory local lymph node assay as a tool to study respiratory sensitizers

NARCIS (Netherlands)

Arts, J.H.E.; Jong, W.H. de; Triel, J.J. van; Schijf, M.A.; Klerk, A. de; Loveren, H. van; Kuper, C.F.

2008-01-01

The local lymph node assay (LLNA) is used to test the potential of low molecular weight (LMW) compounds to induce sensitization via the skin. In the present study, a respiratory LLNA was developed. Male BALB/c mice were exposed head/nose-only during three consecutive days for 45, 90, 180, or 360

A study of the barrier function of the upper respiratory tract covering epithelium in the event of combined respiratory tract injuries

International Nuclear Information System (INIS)

Ivanov, Z.; Kolev, K.; Dermendzhiev, Kh.; Nikolova, M.; Kantardzhiev, V.

1976-01-01

Functional and morphologic impairment of upper respiratory tract mucous membranes after chronic exposure to the three major occupational noxious agents in ore mining - radon-222, silica dust, and respirable dust - has been studied experimentally. Over a 6-month period, rats were given daily treatments, with the agents applied either individually or in combination. Radon-222 (at 1 x 10 -10 Ci/l, corresponding to the maximum permissible concentrotion in uranium mine atmospheres) and respirable dust (dispersed silicogen at 100 mg/m 3 ) were administered four hours daily in toxicological chambers. Monodisperse silica dust was given by tracheal tube, at 50 mg in 1 ml of saline per rat. At the end of the treatment period, the barrier function of the respiratory epithelium was tested, and found to have been affected, by measuring beta radioactivity in blood following introduction into -the animal's nasopharynx of a 32 P-labelled staphylococcus culture. The most severe degree if impairment was found to result from simultaneous exposure to radon and respirable dust. Any of ti'e agents given individually caused a similar degree of impairment. Intratracheal administration of silicic acid anhydride appeared to have no deleterious consequences. The evidence for functional impairment was supported by histologic findings, indicating Jevelopment of ulcerous bronchitis, metaplasia of cylindrical epithelium, etc., after both individual and combined radon exposure. (A.B.)

Elective high-frequency oscillatory ventilation in preterm infants with respiratory distress syndrome: an individual patient data meta-analysis

Directory of Open Access Journals (Sweden)

Offringa Martin

2009-05-01

Full Text Available Abstract Background Despite the considerable amount of evidence from randomized controlled trials and meta-analyses, uncertainty remains regarding the efficacy and safety of high-frequency oscillatory ventilation as compared to conventional ventilation in the early treatment of respiratory distress syndrome in preterm infants. This results in a wide variation in the clinical use of high-frequency oscillatory ventilation for this indication throughout the world. The reasons are an unexplained heterogeneity between trial results and a number of unanswered, clinically important questions. Do infants with different risk profiles respond differently to high-frequency oscillatory ventilation? How does the ventilation strategy affect outcomes? Does the delay – either from birth or from the moment of intubation – to the start of high-frequency oscillation modify the effect of the intervention? Instead of doing new trials, those questions can be addressed by re-analyzing the individual patient data from the existing randomized controlled trials. Methods/Design A systematic review with meta-analysis based on individual patient data. This involves the central collection, validation and re-analysis of the original individual data from each infant included in each randomized controlled trial addressing this question. The study objective is to estimate the effect of high-frequency oscillatory ventilation on the risk for the combined outcome of death or bronchopulmonary dysplasia or a severe adverse neurological event. In addition, it will explore whether the effect of high-frequency oscillatory ventilation differs by the infant's risk profile, defined by gestational age, intrauterine growth restriction, severity of lung disease at birth and whether or not corticosteroids were given to the mother prior to delivery. Finally, it will explore the importance of effect modifying factors such as the ventilator device, ventilation strategy and the delay to the

A rare cause of respiratory distress and edema in neonate: Panhypopituitarism.

Science.gov (United States)

Dursun, Fatma; Kirmizibekmez, Heves; Metin, Fazilet

2017-01-01

Clinical presentation of hypopituitarism may be variable in the neonate. Symptoms are generally nonspecific, ranging from absent to severe, and even life-threatening, due to adrenocorticotrophic hormone deficiency. Presently described is a case of unexplained respiratory distress and edema in a neonate. Initial screening revealed panhypopituitarism. Respiratory distress improved after replacement treatment with hydrocortisone and thyroxine.

Respiratory virus laboratory pandemic planning an surveillance in central Viet Nam, 2008-2010

Directory of Open Access Journals (Sweden)

Trinh Xuan Mai

2012-07-01

Full Text Available Introduction: Laboratory capacity is needed in central Viet Nam to provide early warning to public health authorities of respiratory outbreaks of importance to human health, for example the outbreak of influenza A(H1N1 pandemic in 2009. Polymerase chain reaction (PCR procedures established as part of a capacity-building process were used to conduct prospective respiratory surveillance in a region where few previous studies have been undertaken.Methods: Between October 2008 and September 2010, nose and throat swabs from adults and children (approximately 20 per week presenting with an acute respiratory illness to the Ninh Hoa General Hospital were collected. Same-day PCR testing and result reporting for 13 respiratory viruses were carried out by locally trained scientists.Results: Of 2144 surveillance samples tested, 1235 (57.6% were positive for at least one virus. The most common were influenza A strains (17.9%, with pandemic influenza A(H1N1 2009 and seasonal H3N2 strain accounting for 52% and 43% of these, respectively. Other virus detections included: rhinovirus (12.4%, enterovirus (8.9%, influenza B (8.3%, adenovirus (5.3%, parainfluenza (4.7%, respiratory syncytial virus (RSV (3.9%, human coronavirus (3.0% and human metapneumovirus (0.3%. The detection rate was greatest in the 0–5 year age group. Viral co-infections were identified in 148 (6.9% cases.Discussion: The outbreak in 2009 of the influenza A(H1N1 pandemic strain provided a practical test of the laboratory’s pandemic plan. This study shows that the availability of appropriate equipment and molecular-based testing can contribute to important individual and public health outcomes in geographical locations susceptible to emerging infections.

Evaluation on the implementation of respiratory protection measures in old age homes

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Lee DT

2017-09-01

Full Text Available Diana TF Lee,1 Doris Yu,1 Margaret Ip,2 Jennifer YM Tang3 1The Nethersole School of Nursing, The Chinese University of Hong Kong, 2Department of Microbiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Sha Tin, 3Sau Po Centre on Ageing, The University of Hong Kong, Pok Fu Lam, Hong Kong Purpose: Old age homes (OAHs represent a vulnerable community for influenza outbreaks. Effective implementation of respiratory protection measures has been identified as an effective prevention measure to reduce mortality and morbidity caused by such outbreaks. Yet, relatively little is known about this aspect in these homes. This study evaluated the implementation of respiratory protection measures among infection control officers (ICOs and health care workers (HCWs in these homes in Hong Kong.Patients and methods: A territory-wide, cross-sectional survey was conducted in 87 OAHs. A total of 87 ICOs and 1,763 HCWs (including nurses, health workers, care workers, allied HCWs and assistants completed the questionnaires that evaluated the implementation at the organizational level and individual level, respectively. Generalized estimating equations with unstructured working correlation matrix were used to analyze the simultaneous influence of organizational and individual factors on the implementation.Results: At the organizational level, all homes had a policy on respiratory protection and implementation of such measures was generally adequate. Basic resources such as paper towels/hand dryers and equipment disinfectants, however, were rated as most inadequate by HCWs. Training opportunities were also identified as grossly inadequate. Only less than half of the ICOs and HCWs participated in training on infection control either at the initiation of employment or on a regular basis. Twenty-five percent of HCWs even indicated that they had never participated in any infection control training. At the individual level, hand hygiene, among other

Comparative Effectiveness of Proactive Tobacco Treatment among Smokers with and without Chronic Lower Respiratory Disease.

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Melzer, Anne C; Clothier, Barbara A; Japuntich, Sandra J; Noorbaloochi, Siamak; Hammett, Patrick; Burgess, Diana J; Joseph, Anne M; Fu, Steven S

2018-03-01

Adults with chronic lower respiratory disease differ in their barriers to smoking cessation but also suffer from tobacco-related health concerns, which may motivate quit attempts. Few studies have examined differences in tobacco treatment response between smokers with and without chronic lower respiratory disease. We examined the effectiveness of a proactive outreach program for cessation among smokers with and without chronic lower respiratory disease. Subgroup analysis of the Veterans Victory over Tobacco Study, a pragmatic randomized controlled trial that demonstrated the effectiveness of proactive outreach and the choice of tobacco treatments compared with usual care. Smokers identified via the electronic medical record were proactively offered phone-based counseling and care coordination to receive medication from their Veterans Affairs providers or in-person care. We compared the response among those with and without an International Classification of Diseases, 9th Revision diagnosis of a chronic lower respiratory disease (chronic obstructive pulmonary disease, chronic bronchitis, emphysema, asthma). We used stratification by propensity scores to adjust for imbalanced covariates between groups with and without chronic lower respiratory disease within each treatment arm, using complete case analysis accounting for the stratified sampling by site. The study participants were predominantly older, white, male smokers. Overall, 19.6% had chronic lower respiratory disease. A total of 3,307 had outcome data with the following assignments to the intervention: proactive care: n = 1,272 without chronic lower respiratory disease, n = 301 with chronic lower respiratory disease; usual care: n = 1,387 without chronic lower respiratory disease, n = 347 with chronic lower respiratory disease. A total of 1,888 had both complete baseline and outcome data and were included in the primary analysis. In unadjusted analyses (n = 3,307), among individuals with

Oligonucleotide Therapy for Obstructive and Restrictive Respiratory Diseases

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Wupeng Liao

2017-01-01

Full Text Available Inhaled oligonucleotide is an emerging therapeutic modality for various common respiratory diseases, including obstructive airway diseases like asthma and chronic obstructive pulmonary disease (COPD and restrictive airway diseases like idiopathic pulmonary fibrosis (IPF. The advantage of direct accessibility for oligonucleotide molecules to the lung target sites, bypassing systemic administration, makes this therapeutic approach promising with minimized potential systemic side effects. Asthma, COPD, and IPF are common chronic respiratory diseases, characterized by persistent airway inflammation and dysregulated tissue repair and remodeling, although each individual disease has its unique etiology. Corticosteroids have been widely prescribed for the treatment of asthma, COPD, and IPF. However, the effectiveness of corticosteroids as an anti-inflammatory drug is limited by steroid resistance in severe asthma, the majority of COPD cases, and pulmonary fibrosis. There is an urgent medical need to develop target-specific drugs for the treatment of these respiratory conditions. Oligonucleotide therapies, including antisense oligonucleotide (ASO, small interfering RNA (siRNA, and microRNA (miRNA are now being evaluated both pre-clinically and clinically as potential therapeutics. The mechanisms of action of ASO and siRNA are highly target mRNA specific, ultimately leading to target protein knockdown. miRNA has both biomarker and therapeutic values, and its knockdown by a miRNA antagonist (antagomir has a broader but potentially more non-specific biological outcome. This review will compile the current findings of oligonucleotide therapeutic targets, verified in various respiratory disease models and in clinical trials, and evaluate different chemical modification approaches to improve the stability and potency of oligonucleotides for the treatment of respiratory diseases.

Severe respiratory failure as a presenting feature of an interstitial lung disease associated with anti-synthetase syndrome (ASS).

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Piroddi, Ines Maria Grazia; Ferraioli, Gianluca; Barlascini, Cornelius; Castagneto, Corrado; Nicolini, Antonello

2016-07-01

Anti-synthetase syndrome (ASS) is defined as a heterogeneous connective tissue disorder characterized by the association of an interstitial lung disease (ILD) with or without inflammatory myositis with the presence of anti-aminoacyl-tRNA-synthetase antibodies. ILD is one of the major extra-muscular manifestations of polymyositis and dermatomyositis. We report a case of a patient with dyspnea, cough, and intermittent fever as well as ILD associated ASS in the absence of muscular involvement. This patient was admitted to the emergency department with severe respiratory failure requiring non-invasive ventilation. Our patient's case demonstrates that the diagnosis of ASS may not be obvious. However, its diagnosis leads to appropriate and potentially life-saving treatment. Copyright © 2016 The Japanese Respiratory Society. Published by Elsevier B.V. All rights reserved.

Model-based respiratory motion compensation for emission tomography image reconstruction

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Reyes, M; Malandain, G; Koulibaly, P M; Gonzalez-Ballester, M A; Darcourt, J

2007-01-01

In emission tomography imaging, respiratory motion causes artifacts in lungs and cardiac reconstructed images, which lead to misinterpretations, imprecise diagnosis, impairing of fusion with other modalities, etc. Solutions like respiratory gating, correlated dynamic PET techniques, list-mode data based techniques and others have been tested, which lead to improvements over the spatial activity distribution in lungs lesions, but which have the disadvantages of requiring additional instrumentation or the need of discarding part of the projection data used for reconstruction. The objective of this study is to incorporate respiratory motion compensation directly into the image reconstruction process, without any additional acquisition protocol consideration. To this end, we propose an extension to the maximum likelihood expectation maximization (MLEM) algorithm that includes a respiratory motion model, which takes into account the displacements and volume deformations produced by the respiratory motion during the data acquisition process. We present results from synthetic simulations incorporating real respiratory motion as well as from phantom and patient data

[Respiratory function evaluation in welders taking into account tecnological evolution of individual protection dispositive and risk specific information].

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Boggia, B; Graziuso, G; Carbone, U

2011-01-01

Aim of the study is to evaluate the effect of specific information program on DPI use on the functional respiratory parameters in a group of 15 welders compared with 18 welders not included in the program and 18 workers of industrial sector. Spirometryc parameters were recorded and compared and the results pointed out a significant increase of FEV1 and FVC in the study group compared with welder out of the study while no difference were observed between study group and workers of industrial sector. Results shown that the correct use of DPI could reduce the effects of welding fumes on respiratory tract making these effects equal to the exposure to industrial dusts.

Respiratory mechanics to understand ARDS and guide mechanical ventilation.

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Mauri, Tommaso; Lazzeri, Marta; Bellani, Giacomo; Zanella, Alberto; Grasselli, Giacomo

2017-11-30

As precision medicine is becoming a standard of care in selecting tailored rather than average treatments, physiological measurements might represent the first step in applying personalized therapy in the intensive care unit (ICU). A systematic assessment of respiratory mechanics in patients with the acute respiratory distress syndrome (ARDS) could represent a step in this direction, for two main reasons. Approach and Main results: On the one hand, respiratory mechanics are a powerful physiological method to understand the severity of this syndrome in each single patient. Decreased respiratory system compliance, for example, is associated with low end expiratory lung volume and more severe lung injury. On the other hand, respiratory mechanics might guide protective mechanical ventilation settings. Improved gravitationally dependent regional lung compliance could support the selection of positive end-expiratory pressure and maximize alveolar recruitment. Moreover, the association between driving airway pressure and mortality in ARDS patients potentially underlines the importance of sizing tidal volume on respiratory system compliance rather than on predicted body weight. The present review article aims to describe the main alterations of respiratory mechanics in ARDS as a potent bedside tool to understand severity and guide mechanical ventilation settings, thus representing a readily available clinical resource for ICU physicians.

Individualized exercise prescription in non-alcoholic steatohepatitis: a case report

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Miguel Ángel Sánchez-Martos

2015-03-01

Full Text Available The effect of an individualized exercise programme on a non-alcoholic steatohepatitis case is presented. Before entering the programme the patient was treated with conventional recommendations on diet plus aerobic exercise during fourteen years, without major improvements of his analytical parameters. Two years after including him in a tailored exercise programme, aimed to fulfil the recommendations of the American College of Sports Medicine, his blood markers of liver dysfunction and cardio-metabolic risk tended to improve. Consequently, our data support the idea that in non-alcoholic steatohepatitis the exercise-based therapeutic interventions should be individualized taking into account the cardio-respiratory and muscular fitness of the patient, rather than using generic behavioural recommendations.

Training in multiple breath washout testing for respiratory physiotherapists.

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O'Neill, Katherine; Elborn, J Stuart; Tunney, Michael M; O'Neill, Philip; Rowan, Stephen; Martin, Susan; Bradley, Judy M

2018-03-01

The development of multiple breath washout (MBW) testing in respiratory disease highlights the need for increased awareness amongst respiratory physiotherapists and a potential opportunity for professional development in the use of an important outcome measure for clinical trials. To rationalise how MBW may be a useful assessment tool for respiratory physiotherapists and to describe a local MBW training and certification programme for physiotherapists. The respiratory Multidisciplinary Team in the Belfast Health and Social Care Trust (BHSCT) identified a need for MBW testing to be available to facilitate clinical research and assessment. A 2day training programme consisting of prereading preparation, self-directed learning, theory presentations, practical demonstrations and hands-on practice was developed and delivered. All participants underwent a certification process. We have demonstrated the successful training and certification of clinical and research physiotherapists and encourage other respiratory physiotherapists to consider MBW test training. Copyright © 2017 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

Managing respiratory problems in athletes.

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Hull, James H; Ansley, Les; Robson-Ansley, Paula; Parsons, Jonathan P

2012-08-01

Respiratory problems are common in athletes of all abilities and can significantly impact upon their health and performance. In this article, we provide an overview of respiratory physiology in athletes. We also discuss the assessment and management of common clinical respiratory conditions as they pertain to athletes, including airways disease, respiratory tract infection and pneumothorax. We focus on providing a pragmatic approach and highlight important caveats for the physician treating respiratory conditions in this highly specific population.

Implementing hospital-based surveillance for severe acute respiratory infections caused by influenza and other respiratory pathogens in New Zealand

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Q Sue Huang

2014-05-01

Full Text Available Background: Recent experience with pandemic influenza A(H1N1pdm09 highlighted the importance of global surveillance for severe respiratory disease to support pandemic preparedness and seasonal influenza control. Improved surveillance in the southern hemisphere is needed to provide critical data on influenza epidemiology, disease burden, circulating strains and effectiveness of influenza prevention and control measures. Hospital-based surveillance for severe acute respiratory infection (SARI cases was established in New Zealand on 30 April 2012. The aims were to measure incidence, prevalence, risk factors, clinical spectrum and outcomes for SARI and associated influenza and other respiratory pathogen cases as well as to understand influenza contribution to patients not meeting SARI case definition. Methods/Design: All inpatients with suspected respiratory infections who were admitted overnight to the study hospitals were screened daily. If a patient met the World Health Organization’s SARI case definition, a respiratory specimen was tested for influenza and other respiratory pathogens. A case report form captured demographics, history of presenting illness, co-morbidities, disease course and outcome and risk factors. These data were supplemented from electronic clinical records and other linked data sources. Discussion: Hospital-based SARI surveillance has been implemented and is fully functioning in New Zealand. Active, prospective, continuous, hospital-based SARI surveillance is useful in supporting pandemic preparedness for emerging influenza A(H7N9 virus infections and seasonal influenza prevention and control.

Asymptomatic tracheal MALT lymphoma discovered on spirometric findings presenting with elevated respiratory resistance.

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Kadota, Naoki; Shinohara, Tsutomu; Machida, Hisanori; Nakanishi, Hirofumi; Suehiro, Fumie; Toda, Hiroko; Yoshino, Tadashi; Ogushi, Fumitaka

2015-06-06

Central airway obstruction (CAO) may be caused by various etiologies. However, conventional chest X-rays are rarely diagnostic for patients with CAO. We here described a 64-year-old asymptomatic female with tracheal mucosa-associated lymphoid tissue lymphoma discovered on spirometric findings during a complete physical examination. The plateau of forced expiratory flow was consistent with CAO. A decreased peak expiratory flow rate was noted at least 3 years before the diagnosis, and was attributed to an insufficient effort by the patient. Impulse oscillometric measurements, which were taken during quiet breathing and were effort-independent, suggested elevated respiratory resistance. These abnormalities completely disappeared after radiation therapy. The addition of impulse oscillometry to spirometry may be useful for screening CAO in routine health examinations.

Effect of daily temperature range on respiratory health in Argentina and its modification by impaired socio-economic conditions and PM_1_0 exposures

International Nuclear Information System (INIS)

Carreras, Hebe; Zanobetti, Antonella; Koutrakis, Petros

2015-01-01

Epidemiological investigations regarding temperature influence on human health have focused on mortality rather than morbidity. In addition, most information comes from developed countries despite the increasing evidence that climate change will have devastating impacts on disadvantaged populations living in developing countries. In the present study, we assessed the impact of daily temperature range on upper and lower respiratory infections in Cordoba, Argentina, and explored the effect modification of socio-economic factors and influence of airborne particles We found that temperature range is a strong risk factor for admissions due to both upper and lower respiratory infections, particularly in elderly individuals, and that these effects are more pronounced in sub-populations with low education level or in poor living conditions. These results indicate that socio-economic factors are strong modifiers of the association between temperature variability and respiratory morbidity, thus they should be considered in risk assessments. - Highlights: • Daily temperature range is a strong risk factor for respiratory infections. • Low education level and poor living conditions are strong modifiers of this relationship. • In Cordoba city higher risk for respiratory infections were observed during summertime. - Daily temperature range is a strong risk factor for respiratory infections, particularly for populations with low educational level or poor living conditions.

Respiratory Syncytial Virus

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... with facebook share with twitter share with linkedin Respiratory Syncytial Virus (RSV) Credit: CDC This is the ... the United States. Why Is the Study of Respiratory Syncytial Virus (RSV) a Priority for NIAID? In ...

The impact of HAART on the respiratory complications of HIV infection: longitudinal trends in the MACS and WIHS cohorts.

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Matthew R Gingo

Full Text Available To review the incidence of respiratory conditions and their effect on mortality in HIV-infected and uninfected individuals prior to and during the era of highly active antiretroviral therapy (HAART.Two large observational cohorts of HIV-infected and HIV-uninfected men (Multicenter AIDS Cohort Study [MACS] and women (Women's Interagency HIV Study [WIHS], followed since 1984 and 1994, respectively.Adjusted odds or hazards ratios for incident respiratory infections or non-infectious respiratory diagnoses, respectively, in HIV-infected compared to HIV-uninfected individuals in both the pre-HAART (MACS only and HAART eras; and adjusted Cox proportional hazard ratios for mortality in HIV-infected persons with lung disease during the HAART era.Compared to HIV-uninfected participants, HIV-infected individuals had more incident respiratory infections both pre-HAART (MACS, odds ratio [adjusted-OR], 2.4; 95% confidence interval [CI], 2.2-2.7; p<0.001 and after HAART availability (MACS, adjusted-OR, 1.5; 95%CI 1.3-1.7; p<0.001; WIHS adjusted-OR, 2.2; 95%CI 1.8-2.7; p<0.001. Chronic obstructive pulmonary disease was more common in MACS HIV-infected vs. HIV-uninfected participants pre-HAART (hazard ratio [adjusted-HR] 2.9; 95%CI, 1.02-8.4; p = 0.046. After HAART availability, non-infectious lung diseases were not significantly more common in HIV-infected participants in either MACS or WIHS participants. HIV-infected participants in the HAART era with respiratory infections had an increased risk of death compared to those without infections (MACS adjusted-HR, 1.5; 95%CI, 1.3-1.7; p<0.001; WIHS adjusted-HR, 1.9; 95%CI, 1.5-2.4; p<0.001.HIV infection remained a significant risk for infectious respiratory diseases after the introduction of HAART, and infectious respiratory diseases were associated with an increased risk of mortality.

10 CFR 850.28 - Respiratory protection.

Science.gov (United States)

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false Respiratory protection. 850.28 Section 850.28 Energy... Respiratory protection. (a) The responsible employer must establish a respiratory protection program that complies with the respiratory protection program requirements of 29 CFR 1910.134, Respiratory Protection...

Respiratory viral infections in infancy and school age respiratory outcomes and healthcare costs.

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MacBean, Victoria; Drysdale, Simon B; Yarzi, Muska N; Peacock, Janet L; Rafferty, Gerrard F; Greenough, Anne

2018-03-01

To determine the impact of viral lower respiratory tract infections (LRTIs) in infancy including rhinovirus (RV) and infancy respiratory syncytial virus (RSV), on school age pulmonary function and healthcare utilization in prematurely born children. School age respiratory outcomes would be worse and healthcare utilization greater in children who had viral LRTIs in infancy. Prospective study. A cohort of prematurely born children who had symptomatic LRTIs during infancy documented, was recalled. Pulmonary function was assessed at 5 to 7 years of age and health related costs of care from aged one to follow-up determined. Fifty-one children, median gestational age 33 +6 weeks, were assessed at a median (IQR) age 7.03 (6.37-7.26) years. Twenty-one children had no LRTI, 14 RV LRTI, 10 RSV LRTI, and 6 another viral LRTI (other LRTI). Compared to the no LRTI group, the RV group had a lower FEV 1 (P = 0.033) and the other LRTI group a lower FVC (P = 0.006). Non-respiratory medication costs were higher in the RV (P = 0.018) and RSV (P = 0.013) groups. Overall respiratory healthcare costs in the RV (£153/year) and RSV (£27/year) groups did not differ significantly from the no LRTI group (£56/year); the other LRTI group (£431/year) had higher respiratory healthcare costs (P = 0.042). In moderately prematurely born children, RV and RSV LRTIs in infancy were not associated with higher respiratory healthcare costs after infancy. Children who experienced LRTIs caused by other respiratory viruses (including RV) had higher respiratory healthcare costs and greater pulmonary function impairment. © 2018 Wiley Periodicals, Inc.

Respiratory viruses in children hospitalized for acute lower respiratory tract infection in Ghana.

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Kwofie, Theophilus B; Anane, Yaw A; Nkrumah, Bernard; Annan, Augustina; Nguah, Samuel B; Owusu, Michael

2012-04-10

Acute respiratory tract infections are one of the major causes of morbidity and mortality among young children in developing countries. Information on the viral aetiology of acute respiratory infections in developing countries is very limited. The study was done to identify viruses associated with acute lower respiratory tract infection among children less than 5 years. Nasopharyngeal samples and blood cultures were collected from children less than 5 years who have been hospitalized for acute lower respiratory tract infection. Viruses and bacteria were identified using Reverse Transcriptase Real-Time Polymerase Chain Reaction and conventional biochemical techniques. Out of 128 patients recruited, 33(25.88%%, 95%CI: 18.5% to 34.2%) were positive for one or more viruses. Respiratory Syncytial Virus (RSV) was detected in 18(14.1%, 95%CI: 8.5% to 21.3%) patients followed by Adenoviruses (AdV) in 13(10.2%, 95%CI: 5.5% to 16.7%), Parainfluenza (PIV type: 1, 2, 3) in 4(3.1%, 95%CI: 0.9% to 7.8%) and influenza B viruses in 1(0.8%, 95%CI: 0.0 to 4.3). Concomitant viral and bacterial co-infection occurred in two patients. There were no detectable significant differences in the clinical signs, symptoms and severity for the various pathogens isolated. A total of 61.1% (22/36) of positive viruses were detected during the rainy season and Respiratory Syncytial Virus was the most predominant. The study has demonstrated an important burden of respiratory viruses as major causes of childhood acute respiratory infection in a tertiary health institution in Ghana. The data addresses a need for more studies on viral associated respiratory tract infection.

New and emerging pathogens in canine infectious respiratory disease.

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Priestnall, S L; Mitchell, J A; Walker, C A; Erles, K; Brownlie, J

2014-03-01

Canine infectious respiratory disease is a common, worldwide disease syndrome of multifactorial etiology. This review presents a summary of 6 viruses (canine respiratory coronavirus, canine pneumovirus, canine influenza virus, pantropic canine coronavirus, canine bocavirus, and canine hepacivirus) and 2 bacteria (Streptococcus zooepidemicus and Mycoplasma cynos) that have been associated with respiratory disease in dogs. For some pathogens a causal role is clear, whereas for others, ongoing research aims to uncover their pathogenesis and contribution to this complex syndrome. Etiology, clinical disease, pathogenesis, and epidemiology are described for each pathogen, with an emphasis on recent discoveries or novel findings.

Acute respiratory distress syndrome: epidemiology and management approaches

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Walkey AJ

2012-07-01

Full Text Available Allan J Walkey,1 Ross Summer,1 Vu Ho,1 Philip Alkana21The Pulmonary Center, Boston University School of Medicine, Boston, MA, USA; 2Asthma Research Center, Brigham and Women's Hospital, Boston, MA, USAAbstract: Acute lung injury and the more severe acute respiratory distress syndrome represent a spectrum of lung disease characterized by the sudden onset of inflammatory pulmonary edema secondary to myriad local or systemic insults. The present article provides a review of current evidence in the epidemiology and treatment of acute lung injury and acute respiratory distress syndrome, with a focus on significant knowledge gaps that may be addressed through epidemiologic methods.Keywords: acute lung injury, acute respiratory distress syndrome, review, epidemiology

Epidemiology and clinical presentation of canine distemper disease in dogs and ferrets in Australia, 2006-2014.

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Wyllie, S E; Kelman, M; Ward, M P

2016-07-01

To determine the status and distribution of distemper in Australian dogs and ferrets. Retrospective case series. Cases were identified via a national voluntary disease reporting system, veterinarian groups and a national laboratory database. The geographic distribution, seasonal distribution, signalment and clinical presentation of cases were described using maps and frequency distributions. A total of 48 individually affected dogs and ferrets in 27 case groups were identified, including eight confirmed case groups (> one individual). Confirmed cases were more common in summer and on the central coast of New South Wales and southern Victoria, and occurred exclusively in young, unvaccinated dogs. For dogs there was no obvious sex predilection. A mortality rate of 100% in ferrets and up to 77% in dogs was estimated. Neurological, gastrointestinal and respiratory were the most commonly reported systems affected in dogs and ferrets. There was no evidence that any large, unreported outbreaks occurred during the study period. Continuation of vaccination against canine distemper virus is justified within Australia, particularly for younger dogs. Veterinarians should continue to consider distemper in their differential diagnosis of cases with neurological, gastrointestinal and respiratory presentation. © 2016 Australian Veterinary Association.

Using respiratory rate and thoracic movement to assess respiratory insufficiency in amyotrophic lateral sclerosis: a preliminary study

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Siirala Waltteri

2012-12-01

Full Text Available Abstract Background Hypoventilation due to respiratory insufficiency is the most common cause of death in amyotrophic lateral sclerosis (ALS and non-invasive ventilation (NIV can be used as a palliative treatment. The current guidelines recommend performing spirometry, and recording nocturnal oxyhemoglobin saturation and arterial blood gas analysis to assess the severity of the hypoventilation. We examined whether the respiratory rate and thoracic movement were reliable preliminary clinical signs in the development of respiratory insufficiency in patients with ALS. Methods We measured the respiratory rate and thoracic movement, performed respiratory function tests and blood gas analysis, and recorded subjective hypoventilation symptoms in 42 ALS patients over a 7-year period. We recommended NIV if the patient presented with hypoventilation matching the current guidelines. We divided patients retrospectively into two groups: those to whom NIV was recommended within 6 months of the diagnosis (Group 1 and those to whom NIV was recommended 6 months after the diagnosis (Group 2. We used the Mann Whitney U test for comparisons between the two groups. Results The mean partial pressure of arterial carbon dioxide in the morning in Group 1 was 6.3 (95% confidence interval 5.6–6.9 kPa and in Group 2 5.3 (5.0–5.6 kPa (p = 0.007. The mean respiratory rate at the time of diagnosis in Group 1 was 21 (18–24 breaths per minute and 16 (14–18 breaths per minute in Group 2 (p = 0.005. The mean thoracic movement was 2.9 (2.2–3.6 cm in Group 1 and 4.0 (3.4–4.8 cm in Group 2 (p = 0.01. We observed no other differences between the groups. Conclusions Patients who received NIV within six months of the diagnosis of ALS had higher respiratory rates and smaller thoracic movement compared with patients who received NIV later. Further studies with larger numbers of patients are needed to establish if these measurements can be used as a marker of hypoventilation

Using respiratory rate and thoracic movement to assess respiratory insufficiency in amyotrophic lateral sclerosis: a preliminary study.

Science.gov (United States)

Siirala, Waltteri; Saaresranta, Tarja; Vuori, Arno; Salanterä, Sanna; Olkkola, Klaus T; Aantaa, Riku

2012-12-27

Hypoventilation due to respiratory insufficiency is the most common cause of death in amyotrophic lateral sclerosis (ALS) and non-invasive ventilation (NIV) can be used as a palliative treatment. The current guidelines recommend performing spirometry, and recording nocturnal oxyhemoglobin saturation and arterial blood gas analysis to assess the severity of the hypoventilation. We examined whether the respiratory rate and thoracic movement were reliable preliminary clinical signs in the development of respiratory insufficiency in patients with ALS. We measured the respiratory rate and thoracic movement, performed respiratory function tests and blood gas analysis, and recorded subjective hypoventilation symptoms in 42 ALS patients over a 7-year period. We recommended NIV if the patient presented with hypoventilation matching the current guidelines. We divided patients retrospectively into two groups: those to whom NIV was recommended within 6 months of the diagnosis (Group 1) and those to whom NIV was recommended 6 months after the diagnosis (Group 2). We used the Mann Whitney U test for comparisons between the two groups. The mean partial pressure of arterial carbon dioxide in the morning in Group 1 was 6.3 (95% confidence interval 5.6-6.9) kPa and in Group 2 5.3 (5.0-5.6) kPa (p = 0.007). The mean respiratory rate at the time of diagnosis in Group 1 was 21 (18-24) breaths per minute and 16 (14-18) breaths per minute in Group 2 (p = 0.005). The mean thoracic movement was 2.9 (2.2-3.6) cm in Group 1 and 4.0 (3.4-4.8) cm in Group 2 (p = 0.01). We observed no other differences between the groups. Patients who received NIV within six months of the diagnosis of ALS had higher respiratory rates and smaller thoracic movement compared with patients who received NIV later. Further studies with larger numbers of patients are needed to establish if these measurements can be used as a marker of hypoventilation in ALS.

Community Respiratory Viruses as a Cause of Lower Respiratory Tract Infections Following Suppressive Chemotherapy in Cancer Patients

International Nuclear Information System (INIS)

El-Mahallawy, H.A.; Ibrahim, M.H.; Shalaby, L.; Kandil

2005-01-01

Community respiratory viruses are an important cause of respiratory disease in the immunocompromised patients with cancer. To evaluate the occurrence and clinical significance of respiratory virus infections in hospitalized cancer patients at National Cancer Institute, Cairo University, during anticancer treatment, we studied cases that developed episodes of lower respiratory tract infections (LRTI). Patients and Methods: Thirty patients with LRTI were studied clinically, radiologically, and microbiologically. Sputum cultures were done and an immunofluorescence search for IgM antibodies of influenza A and B, parainfluenza serotypes 1,2 and 3, adenovirus, respiratory syncytial virus, Legionella pneumophila, Coxiella burnettii, Chlamydia pneumoniae, and Mycoplasma pneumoniae were performed on serum samples of patients. The main presenting symptom was cough and expectoration. Hematologic malignancy was the underlying disease in 86.6% of cases. Blood cultures were positive in II patients (36.6%) only. Sputum cultures revealed a bacterial pathogen in [3 cases and fungi in 3; whereas viral and atypical bacterial lgM antibodies were detected in 13 and 4 patients; respectively. Influenza virus was the commonest virus detected, being of type B in 4 cases, type A in one case and mixed A and B in another 5 cases; followed by RSV in 5 patients. Taken together, bacteria were identified as a single cause of LRTI in 10 cases, viruses in 6, fungi in 3 and mixed causes in 7. Still, there were 4 undiagnosed cases. This study showed that respiratory viruses are common in LRTI, either as a single cause or mixed with bacterial pathogens. in hospitalized cancer patients receiving chemotherapy. Diagnostic tests for respiratory viruses should be incorporated in the routine diagnostic study of patients with hematologic malignancies. Also, it must be emphasized that early CT chest is crucial as a base-line prior to initiation of anti-fungal or anti-viral therapy. In cancer patients with a

[Respiratory depression in delirium tremens patients treated with phenobarbital. A retrospective study

DEFF Research Database (Denmark)

Lutzen, L.; Poulsen, L.M.; Ulrichsen, J.

2008-01-01

INTRODUCTION: Delirium tremens (DT) is the most severe manifestation of alcohol withdrawal which--if untreated--has a high rate of mortality. Barbiturates are the most effective drug but respiratory depression may occur. In the present study we investigated the frequency of respiratory problems...... to ketoacidosis. The death could not be attributed to the phenobarbital treatment. CONCLUSION: In conclusion, we found that the frequency of phenobarbital-induced respiratory depression was low. However, if the DT was complicated with pneumonia, life-threatening respiratory insufficiency could be the outcome...

Respiratory physiology during early life.

Science.gov (United States)

Stocks, J

1999-08-01

Despite the rapid adaptation to extrauterine life, the respiratory system of an infant is not simply a miniaturized version of that of an adult, since the rapid somatic growth that occurs during the first year of life is accompanied by major developmental changes in respiratory physiology. The highly compliant chest wall of the infant results in relatively low transpulmonary pressures at end expiration with increased tendency of the small peripheral airways to close during tidal breathing. This not only impairs gas exchange and ventilation-perfusion balance, particularly in dependent parts of the lung, but, together with the small absolute size of the airways, renders the infant and young child particularly susceptible to airway obstruction. Premature airways are highly compliant structures compared with those of mature newborns or adults. This increased compliance can cause airway collapse, resulting in increased airways resistance, flow limitation, poor gas exchange and increased work of breathing. Although there is clear evidence that airway reactivity is present from birth, its role in wheezing lower respiratory tract illnesses in young infants may be overshadowed by pre-existing abnormalities of airway geometry and lung mechanics, or by pathological changes such as airway oedema and mucus hypersecretion. Attempts to assess age-related changes in airway reactivity or response to aerosol therapy in the very young is confounded by changes in breathing patterns and the fact that infants are preferential nose breathers. There is increasing evidence that pre-existing abnormalities of respiratory function, associated with adverse events during foetal life (including maternal smoking during pregnancy), and familial predisposition to wheezing are important determinants of wheezing illnesses during the first years of life. This emphasizes the need to identify and minimize any factors that threaten the normal development of the lung during this critical period if

Adult respiratory distress syndrome

International Nuclear Information System (INIS)

Svendsen, J.; Jespersen, J.; Skjoedt, T.

1986-01-01

Our present-day knowledge concerning the clinico-chemical and radiological findings in adult respiratory distress syndrome are described. Three typical case histories have been selected to illustrate this condition; they were due to multiple trauma or sepsis. It is stressed that radiology is in a key position for making the diagnosis and for observing the course of the illness. (orig) [de

The respiratory local lymph node assay as a tool to study respiratory sensitizers.

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Arts, Josje H E; de Jong, Wim H; van Triel, Jos J; Schijf, Marcel A; de Klerk, Arja; van Loveren, Henk; Kuper, C Frieke

2008-12-01

The local lymph node assay (LLNA) is used to test the potential of low molecular weight (LMW) compounds to induce sensitization via the skin. In the present study, a respiratory LLNA was developed. Male BALB/c mice were exposed head/nose-only during three consecutive days for 45, 90, 180, or 360 min/day to various LMW allergens. Ear application (skin LLNA) was used as a positive control. Negative controls were exposed to the vehicle. Three days after the last exposure, proliferation was determined in the draining mandibular lymph nodes, and the respiratory tract was examined microscopically. Upon inhalation, the allergens trimellitic anhydride, phthalic anhydride, hexamethylene diisocyanate, toluene diisocyanate, isophorone diisocyanate (IPDI), dinitrochlorobenzene, and oxazolone were positive and showed stimulation indices (SIs) up to 11, whereas trimeric IPDI, formaldehyde, and methyl salicylate were negative (viz. SI LLNA.

Avaliação da mecânica ventilatória em indivíduos com disfunção têmporo-mandibular e assintomáticos Evaluation of ventilatory mechanics in individuals with temporomandibular dysfunction and in asymptomatic individuals

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F Pasinato

2006-09-01

15 asymptomatic individuals. The participants were evaluated to verify the presence and degree of TMD. A respiratory evaluation was carried out by means of inspecting the ventilatory pattern and type, measuring the chest perimeter, testing the respiratory muscle strength and investigating the history of respiratory diseases. RESULTS: The mouth (30% and mixed (15% breathing types and the apical ventilatory pattern (45% predominated in individuals with TMD. There was less chest expandability and a statistically significantly smaller abdominal amplitude index in individuals with TMD. These individuals also presented higher incidence of obstructive respiratory diseases in the upper (70% and lower (45% airways, in relation to the asymptomatic individuals. CONCLUSION: The results indicate that there is an influence from ventilatory mechanics on the occurrence of temporomandibular dysfunction.

[Respiratory symptoms and atmospheric pollution and respiratory symptoms in the general population].

Science.gov (United States)

Simon, I; Charpin, D

2010-06-01

Epidemiological studies on air pollution have mainly been interested in the effects of short- or long-term exposure on patients suffering from respiratory illnesses. Fewer studies have addressed the acute effects of air pollution on respiratory symptoms in the general population. We conducted a review of the literature over the last 16years that has addressed the impact of atmospheric pollution on respiratory symptoms in the general population to estimate the magnitude of effect. The majority of studies demonstrated a significant association between exposure to air pollutants and the occurrence of respiratory symptoms, without any threshold. Although a link between atmospheric pollution and respiratory symptoms has been demonstrated, knowledge of the effects of specific air pollutants and the effect of pollution on particular vulnerable groups (infants, young children, the elderly) is still limited. There is a need for further studies in this area. Copyright 2010 SPLF. Published by Elsevier Masson SAS. All rights reserved.

Respiratory symptoms and lung function in bauxite miners.

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Beach, J R; de Klerk, N H; Fritschi, L; Sim, M R; Musk, A W; Benke, G; Abramson, M J; McNeil, J J

2001-09-01

To determine whether cumulative bauxite exposure is associated with respiratory symptoms or changes in lung function in a group of bauxite miners. Current employees at three bauxite mines in Australia were invited to participate in a survey comprising: questionnaire on demographic details, respiratory symptoms, and work history; skin prick tests for four common aeroallergens; and spirometry. A task exposure matrix was constructed for bauxite exposure in all tasks in all jobs based on monitoring data. Data were examined for associations between cumulative bauxite exposure, and respiratory symptoms and lung function, by regression analyses. The participation rate was 86%. Self-reported work-related respiratory symptoms were reported by relatively few subjects (1.5%-11.8%). After adjustment for age and smoking no significant differences in the prevalence of respiratory symptoms were identified between subjects, in the quartiles of cumulative bauxite exposure distribution. The forced expiratory volume in I s (FEV1) of the exposed group was found to be significantly lower than that for the unexposed group. After adjustment for age, height, and smoking there were no statistically significant differences between quartiles in FEVI, forced vital capacity (FVC) and FEVl/FVC ratio. These data provide little evidence of a serious adverse effect on respiratory health associated with exposure to bauxite in an open-cut bauxite mine in present day conditions.

Effect of Parkinson's Disease on the Production of Structured and Unstructured Speaking Tasks: Respiratory Physiologic and Linguistic Considerations

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Huber, Jessica E.; Darling, Meghan

2011-01-01

Purpose: To examine the effects of cognitive-linguistic deficits and respiratory physiologic changes on respiratory support for speech in individuals with Parkinson's disease (PD) using two speech tasks: reading and extemporaneous speech. Method: Five women with PD, 9 men with PD, and 14 age- and sex-matched control participants read a passage and…

Respiratory viruses in children hospitalized for acute lower respiratory tract infection in Ghana

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Kwofie Theophilus B

2012-04-01

Full Text Available Abstract Background Acute respiratory tract infections are one of the major causes of morbidity and mortality among young children in developing countries. Information on the viral aetiology of acute respiratory infections in developing countries is very limited. The study was done to identify viruses associated with acute lower respiratory tract infection among children less than 5 years. Method Nasopharyngeal samples and blood cultures were collected from children less than 5 years who have been hospitalized for acute lower respiratory tract infection. Viruses and bacteria were identified using Reverse Transcriptase Real-Time Polymerase Chain Reaction and conventional biochemical techniques. Results Out of 128 patients recruited, 33(25.88%%, 95%CI: 18.5% to 34.2% were positive for one or more viruses. Respiratory Syncytial Virus (RSV was detected in 18(14.1%, 95%CI: 8.5% to 21.3% patients followed by Adenoviruses (AdV in 13(10.2%, 95%CI: 5.5% to 16.7%, Parainfluenza (PIV type: 1, 2, 3 in 4(3.1%, 95%CI: 0.9% to 7.8% and influenza B viruses in 1(0.8%, 95%CI: 0.0 to 4.3. Concomitant viral and bacterial co-infection occurred in two patients. There were no detectable significant differences in the clinical signs, symptoms and severity for the various pathogens isolated. A total of 61.1% (22/36 of positive viruses were detected during the rainy season and Respiratory Syncytial Virus was the most predominant. Conclusion The study has demonstrated an important burden of respiratory viruses as major causes of childhood acute respiratory infection in a tertiary health institution in Ghana. The data addresses a need for more studies on viral associated respiratory tract infection.

Ocular Tropism of Respiratory Viruses

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Rota, Paul A.; Tumpey, Terrence M.

2013-01-01

SUMMARY Respiratory viruses (including adenovirus, influenza virus, respiratory syncytial virus, coronavirus, and rhinovirus) cause a broad spectrum of disease in humans, ranging from mild influenza-like symptoms to acute respiratory failure. While species D adenoviruses and subtype H7 influenza viruses are known to possess an ocular tropism, documented human ocular disease has been reported following infection with all principal respiratory viruses. In this review, we describe the anatomical proximity and cellular receptor distribution between ocular and respiratory tissues. All major respiratory viruses and their association with human ocular disease are discussed. Research utilizing in vitro and in vivo models to study the ability of respiratory viruses to use the eye as a portal of entry as well as a primary site of virus replication is highlighted. Identification of shared receptor-binding preferences, host responses, and laboratory modeling protocols among these viruses provides a needed bridge between clinical and laboratory studies of virus tropism. PMID:23471620

Respiratory virus laboratory pandemic planning and surveillance in central Viet Nam, 2008–2010

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Chien, Bui Trong; Papadakis, Georgina; Druce, Julian; Birch, Chris; Chibo, Doris; An, Truong Phuoc; Trang, Le Thi Kim; Trieu, Nguyen Bao; Thuy, Doan Thi Thanh; Catton, Mike; Mai, Trinh Xuan

2012-01-01

Introduction Laboratory capacity is needed in central Viet Nam to provide early warning to public health authorities of respiratory outbreaks of importance to human health, for example the outbreak of influenza A(H1N1) pandemic in 2009. Polymerase chain reaction (PCR) procedures established as part of a capacity-building process were used to conduct prospective respiratory surveillance in a region where few previous studies have been undertaken. Methods Between October 2008 and September 2010, nose and throat swabs from adults and children (approximately 20 per week) presenting with an acute respiratory illness to the Ninh Hoa General Hospital were collected. Same-day PCR testing and result reporting for 13 respiratory viruses were carried out by locally trained scientists. Results Of 2144 surveillance samples tested, 1235 (57.6%) were positive for at least one virus. The most common were influenza A strains (17.9%), with pandemic influenza A(H1N1) 2009 and seasonal H3N2 strain accounting for 52% and 43% of these, respectively. Other virus detections included: rhinovirus (12.4%), enterovirus (8.9%), influenza B (8.3%), adenovirus (5.3%), parainfluenza (4.7%), respiratory syncytial virus (RSV) (3.9%), human coronavirus (3.0%) and human metapneumovirus (0.3%). The detection rate was greatest in the 0–5 year age group. Viral co-infections were identified in 148 (6.9%) cases. Discussion The outbreak in 2009 of the influenza A(H1N1) pandemic strain provided a practical test of the laboratory’s pandemic plan. This study shows that the availability of appropriate equipment and molecular-based testing can contribute to important individual and public health outcomes in geographical locations susceptible to emerging infections. PMID:23908924

Effects of Presentation Mode on Veridical and False Memory in Individuals with Intellectual Disability

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Carlin, Michael; Toglia, Michael P.; Belmonte, Colleen; DiMeglio, Chiara

2012-01-01

In the present study the effects of visual, auditory, and audio-visual presentation formats on memory for thematically constructed lists were assessed in individuals with intellectual disability and mental age-matched children. The auditory recognition test included target items, unrelated foils, and two types of semantic lures: critical related…

SPECT acquisition using dynamic projections: a novel approach for data-driven respiratory gating

International Nuclear Information System (INIS)

Hutton, B.F.; Hatton, R.L.; Yip, N.

2002-01-01

Full text: Movement of the heart due to respiration has been previously demonstrated to produce potentially serious artefacts. On-line respiratory gating is difficult, as it requires a high level of patient cooperation. We demonstrate that use of dynamic acquisition of projections permits identification of the respiratory dynamics, allowing retrospective selection of data corresponding to a fixed point in the respiratory cycle. To demonstrate the feasibility of the technique a dynamic study was acquired just prior to myocardial per-fusion SPECT acquisition, using 5 frames/sec for 20 seconds (64*64 matrix) in anterior and lateral projections (using a dual-head right-angled configuration). The dynamic was processed a) by compressing frames in the transverse direction so as to illustrate time dependence, b) by plotting the centre of mass in the axial direction as a function of time. Respiratory motion was enhanced by use of temporal smoothing and intensity thresholding. In ten patients studied the cyclic pattern of motion due to respiratory dynamics was clearly visible in nine. Respiration typically resulted in around 1cm axial translation but in some individuals, movements as large as 3 cm were identified. The respiration rate ranged from 12-18 /min in agreement with independent observation of the patient's breathing pattern. These results suggest that retrospective respiratory gating is feasible without the need for any external respiratory monitoring device, provide that dynamic acquisition of SPECT projections is implemented. Correction for respiratory motion may also be feasible using this technique. Copyright (2002) The Australian and New Zealand Society of Nuclear Medicine Inc

Real-world comparison of two molecular methods for detection of respiratory viruses

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Miller E Kathryn

2011-06-01

Full Text Available Abstract Background Molecular polymerase chain reaction (PCR based assays are increasingly used to diagnose viral respiratory infections and conduct epidemiology studies. Molecular assays have generally been evaluated by comparing them to conventional direct fluorescent antibody (DFA or viral culture techniques, with few published direct comparisons between molecular methods or between institutions. We sought to perform a real-world comparison of two molecular respiratory viral diagnostic methods between two experienced respiratory virus research laboratories. Methods We tested nasal and throat swab specimens obtained from 225 infants with respiratory illness for 11 common respiratory viruses using both a multiplex assay (Respiratory MultiCode-PLx Assay [RMA] and individual real-time RT-PCR (RT-rtPCR. Results Both assays detected viruses in more than 70% of specimens, but there was discordance. The RMA assay detected significantly more human metapneumovirus (HMPV and respiratory syncytial virus (RSV, while RT-rtPCR detected significantly more influenza A. We speculated that primer differences accounted for these discrepancies and redesigned the primers and probes for influenza A in the RMA assay, and for HMPV and RSV in the RT-rtPCR assay. The tests were then repeated and again compared. The new primers led to improved detection of HMPV and RSV by RT-rtPCR assay, but the RMA assay remained similar in terms of influenza detection. Conclusions Given the absence of a gold standard, clinical and research laboratories should regularly correlate the results of molecular assays with other PCR based assays, other laboratories, and with standard virologic methods to ensure consistency and accuracy.

Critically Ill Patients With the Middle East Respiratory Syndrome: A Multicenter Retrospective Cohort Study.

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Arabi, Yaseen M; Al-Omari, Awad; Mandourah, Yasser; Al-Hameed, Fahad; Sindi, Anees A; Alraddadi, Basem; Shalhoub, Sarah; Almotairi, Abdullah; Al Khatib, Kasim; Abdulmomen, Ahmed; Qushmaq, Ismael; Mady, Ahmed; Solaiman, Othman; Al-Aithan, Abdulsalam M; Al-Raddadi, Rajaa; Ragab, Ahmed; Al Mekhlafi, Ghaleb A; Al Harthy, Abdulrahman; Kharaba, Ayman; Ahmadi, Mashael Al; Sadat, Musharaf; Mutairi, Hanan Al; Qasim, Eman Al; Jose, Jesna; Nasim, Maliha; Al-Dawood, Abdulaziz; Merson, Laura; Fowler, Robert; Hayden, Frederick G; Balkhy, Hanan H

2017-10-01

To describe patient characteristics, clinical manifestations, disease course including viral replication patterns, and outcomes of critically ill patients with severe acute respiratory infection from the Middle East respiratory syndrome and to compare these features with patients with severe acute respiratory infection due to other etiologies. Retrospective cohort study. Patients admitted to ICUs in 14 Saudi Arabian hospitals. Critically ill patients with laboratory-confirmed Middle East respiratory syndrome severe acute respiratory infection (n = 330) admitted between September 2012 and October 2015 were compared to consecutive critically ill patients with community-acquired severe acute respiratory infection of non-Middle East respiratory syndrome etiology (non-Middle East respiratory syndrome severe acute respiratory infection) (n = 222). None. Although Middle East respiratory syndrome severe acute respiratory infection patients were younger than those with non-Middle East respiratory syndrome severe acute respiratory infection (median [quartile 1, quartile 3] 58 yr [44, 69] vs 70 [52, 78]; p < 0.001), clinical presentations and comorbidities overlapped substantially. Patients with Middle East respiratory syndrome severe acute respiratory infection had more severe hypoxemic respiratory failure (PaO2/FIO2: 106 [66, 160] vs 176 [104, 252]; p < 0.001) and more frequent nonrespiratory organ failure (nonrespiratory Sequential Organ Failure Assessment score: 6 [4, 9] vs 5 [3, 7]; p = 0.002), thus required more frequently invasive mechanical ventilation (85.2% vs 73.0%; p < 0.001), oxygen rescue therapies (extracorporeal membrane oxygenation 5.8% vs 0.9%; p = 0.003), vasopressor support (79.4% vs 55.0%; p < 0.001), and renal replacement therapy (48.8% vs 22.1%; p < 0.001). After adjustment for potential confounding factors, Middle East respiratory syndrome was independently associated with death compared to non-Middle East respiratory syndrome severe acute respiratory

Respiratory virus detection during hospitalisation for lower respiratory tract infection in children under 2 years in South Auckland, New Zealand.

Science.gov (United States)

Trenholme, Adrian A; Best, Emma J; Vogel, Alison M; Stewart, Joanna M; Miller, Charissa J; Lennon, Diana R

2017-06-01

To describe respiratory virus detection in children under 2 years of age in a population admitted with lower respiratory infection and to assess correlation with measures of severity. Nasopharyngeal aspirates from infants admitted with lower respiratory tract infection (n = 1645) over a 3-year time period were tested by polymerase chain reaction. We collected epidemiological and clinical data on all children. We assessed the correlation of presence of virus with length of hospital stay, intensive care admission and consolidation on chest X-ray. Of the children admitted 34% were Maori, 43% Pacific and 75% lived in areas in the bottom quintile for socio-economic deprivation. A virus was found in 94% of those tested including 30% with multiple viruses. Picornavirus was present in 59% including 34% as the sole virus. Respiratory syncytial virus was found in 39%. Virus co-detection was not associated with length of stay, chest X-ray changes or intensive care unit admission. In this disadvantaged predominately Maori and Pacific population, picornavirus is commonly found as a sole virus, respiratory syncytial virus is frequent but immunisation preventable influenza is infrequent. We did not find that co-detection of viruses was linked to severity. © 2017 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).

Achalasia and Respiratory Symptoms: Effect of Laparoscopic Heller Myotomy.

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Andolfi, Ciro; Kavitt, Robert T; Herbella, Fernando A M; Patti, Marco G

2016-09-01

Dysphagia and regurgitation are considered typical symptoms of achalasia. However, there is mounting evidence that some achalasia patients may also experience respiratory symptoms such as cough, wheezing, and hoarseness. The aims of this study were to determine: (1) what percentage of achalasia patients experience respiratory symptoms and (2) the effect of a laparoscopic Heller myotomy and Dor fundoplication on the typical and respiratory symptoms of achalasia. Between May 2008 and December 2015, 165 patients with achalasia were referred for treatment to the Center for Esophageal Diseases of the University of Chicago. Patients had preoperatively a barium swallow, endoscopy, and esophageal manometry. All patients underwent a Heller myotomy and Dor fundoplication. Based on the presence of respiratory symptoms, patients were divided into two groups: group A, 98 patients (59%) without respiratory symptoms and group B, 67 patients (41%) with respiratory symptoms. The preoperative Eckardt score was similar in the two groups (6.5 ± 2.1 versus 6.4 ± 2.0). The mean esophageal diameter was 27.7 ± 10.8 mm in group A and 42.6 ± 20.1 mm in group B (P myotomy that extended for 5 cm on the esophagus and 2.5 cm onto the gastric wall. At a median postoperative follow-up of 17 months, the Eckardt score improved significantly and similarly in the two groups (0.3 ± 0.8 versus 0.3 ± 1.0). Respiratory symptoms improved or resolved in 62 patients (92.5%). The results of this study showed that: (1) respiratory symptoms were present in 41% of patients; (2) patients with respiratory symptoms had a more dilated esophagus; and (3) surgical treatment resolved or improved respiratory symptoms in 92.5% of patients. This study underlines the importance of investigating the presence of respiratory symptoms along with the more common symptoms of achalasia and of early treatment before lung damage occurs.

Pulmonary Function and Respiratory Health of Military Personnel Before Southwest Asia Deployment.

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Skabelund, Andrew J; Rawlins, Frederic A; McCann, Edward T; Lospinoso, Joshua A; Burroughs, Lorraine; Gallup, Roger A; Morris, Michael J

2017-09-01

Significant concern exists regarding the respiratory health of military personnel deployed to Southwest Asia, given their exposures to numerous environmental hazards. Although the deployed military force is generally assumed to be fit, the pre-deployment respiratory health of these individuals is largely unknown. Soldiers deploying to Southwest Asia were recruited from the pre-deployment processing center at Fort Hood, Texas. Participants completed a general and respiratory health questionnaire and performed baseline spirometry. One thousand six hundred ninety-three pre-deployment evaluations were completed. The average age of the participants was 32.2 y, and 83.1% were male. More than one third of surveyed solders had a smoking history, 73% were overweight or obese, and 6.2% reported a history of asthma. Abnormal spirometry was found in 22.3% of participants. Soldiers with abnormal spirometry reported more asthma (10.1% vs 5.1%, P military personnel that delineates factors potentially associated with the development of pulmonary symptoms and/or disease. This study suggests that deploying soldiers are older, heavier, frequently smoke, and may have undiagnosed pre-deployment lung disease. Abnormal spirometry is common but may not represent underlying disease. Self-reported asthma, wheezing, and slower 2-mile run times were predictive of abnormal spirometry. Pre-deployment evaluation of military personnel identified numerous soldiers with active pulmonary symptoms and abnormal spirometry. When combined with questions regarding asthma history, wheezing and exercise intolerance, spirometry may identify individuals at risk for deployment-related respiratory complaints. Copyright © 2017 by Daedalus Enterprises.

RESPIRATORY GYMNASTICS AS A REHABILITATION MEANS FOR THE PRESCHOOL CHILDREN WITH THE RESPIRATORY PATHOLOGY

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T.A. Shemyakina

2007-01-01

Full Text Available The researchers analyzed the efficacy of the new medical technology aimed at rehabilitation of the preschool children with the respiratory pathology. 177 children aged between 2 and 7 with recurrent respiratory diseases, bronchial asthma or chronic pathology of the end organs have been examined for 9 months. It was uncovered that among children (n = 90, who performed the sets of the therapeutic physical training and respiratory gymnastics according to the methods developed by the authors, the recurrence of the acute respiratory diseases and exacerbations of bronchial asthma was lower by 1,83 and 1,86 timers respectively. Besides, among children of this group the researchers noted the significant improvement of the physical qualities, spirometric indices and cytological picture of the substance removed from the nasal cavity if compared with the children from the screening group (n = 87, who performed the sets of the conventional gymnastics at the physical training lessons. Thus, the researchers proved the high efficacy of the proposed technology for the rehabilitation of the children, suffering from the chronic respiratory pathology.Key words: acute respiratory diseases, asthma, therapeutic physical training, respiratory gymnastics, children.

Maternal and neonatal outcomes of respiratory failure during pregnancy

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Chen-Yiu Hung

2018-05-01

Full Text Available Background: Obstetric patients comprise a limited portion of intensive care unit patients, but they often present with unfamiliar conditions and exhibit the potential for catastrophic deterioration. This study evaluated the maternal and neonatal outcomes of respiratory failure during pregnancy. Methods: Information on 71 patients at >25 weeks gestation in the ICU with respiratory failure was recorded between 2009 and 2013. The characteristics and outcomes of mothers and fetuses were determined through a retrospective chart review and evaluated using Student's t test, chi-square test, and Fisher's exact test. Results: The leading causes of respiratory failure were postpartum hemorrhage and severe preeclampsia in the obstetric causes group and pneumonia in the nonobstetric causes group during pregnancy and the peripartum period. The non-obstetric causes group exhibited a higher incidence of acute respiratory distress syndrome and renal replacement therapy as well as requiring more ventilator days. The patients in the obstetric causes group showed significant improvement after delivery in the partial pressure of arterial oxygen to the fraction of inspired oxygen and peak inspiratory pressure decrease. Both groups exhibited high incidences of neonatal respiratory distress syndrome. Neonatal complications resulting from meconium aspiration syndrome (MAS and sepsis were more common in the non-obstetric causes group; however, neurological development impairment was more common in the obstetric causes group. Conclusion: Obstetric cause was associated with longer ventilator free days and fewer episodes of ARDS after delivery. Neonatal complications resulting from different etiologies of respiratory failure were found to differ. Keywords: Acute respiratory distress syndrome, Neonatal, Obstetric, Outcome, Respiratory failure

Global alliance against chronic respiratory diseases in Italy (GARD-Italy): strategy and activities.

Science.gov (United States)

Laurendi, Giovanna; Mele, Sonia; Centanni, Stefano; Donner, Claudio F; Falcone, Franco; Frateiacci, Sandra; Lazzeri, Marta; Mangiacavallo, Antonino; Indinnimeo, Luciana; Viegi, Giovanni; Pisanti, Paola; Filippetti, Giuseppe

2012-01-01

The steady increase in incidence of chronic respiratory disease (CRD) now constitutes a serious public health problem. CRDs are often underdiagnosed and many patients are not diagnosed until the CRD is too severe to prevent normal daily activities. The prevention of CRDs and reducing their social and individual impacts means modifying environmental and social factors and improving diagnosis and treatment. Prevention of risk factors (tobacco smoke, allergens, occupational agents, indoor/outdoor air pollution) will significantly impact on morbidity and mortality. The Italian Ministry of Health (MoH) has made respiratory disease prevention a top priority and is implementing a comprehensive strategy with policies against tobacco smoking, indoor/outdoor pollution, obesity, and communicable diseases. Presently these actions are not well coordinated. The Global Alliance against Chronic Respiratory Diseases (GARD), set up by the World Health Organization, envisages national bodies; the GARD initiative in Italy, launched 11/6/2009, represents a great opportunity for the MoH. Its main objective is to promote the development of a coordinated CRD program in Italy. Effective prevention implies setting up a health policy with the support of healthcare professionals and citizen associations at national, regional, and district levels. What is required is a true inter-institutional synergy: respiratory diseases prevention cannot and should not be the responsibility of doctors alone, but must involve politicians/policymakers, as well as the media, local institutions, and schools, etc. GARD could be a significant experience and a great opportunity for Italy to share the GARD vision of a world where all people can breathe freely. Copyright © 2011 Elsevier Ltd. All rights reserved.

Advances in Diagnosis of Respiratory Diseases of Small Ruminants

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Sandip Chakraborty

2014-01-01

Full Text Available Irrespective of aetiology, infectious respiratory diseases of sheep and goats contribute to 5.6 percent of the total diseases of small ruminants. These infectious respiratory disorders are divided into two groups: the diseases of upper respiratory tract, namely, nasal myiasis and enzootic nasal tumors, and diseases of lower respiratory tract, namely, peste des petits ruminants (PPR, parainfluenza, Pasteurellosis, Ovine progressive pneumonia, mycoplasmosis, caprine arthritis encephalitis virus, caseous lymphadenitis, verminous pneumonia, and many others. Depending upon aetiology, many of them are acute and fatal in nature. Early, rapid, and specific diagnosis of such diseases holds great importance to reduce the losses. The advanced enzyme-linked immunosorbent assays (ELISAs for the detection of antigen as well as antibodies directly from the samples and molecular diagnostic assays along with microsatellites comprehensively assist in diagnosis as well as treatment and epidemiological studies. The present review discusses the advancements made in the diagnosis of common infectious respiratory diseases of sheep and goats. It would update the knowledge and help in adapting and implementing appropriate, timely, and confirmatory diagnostic procedures. Moreover, it would assist in designing appropriate prevention protocols and devising suitable control strategies to overcome respiratory diseases and alleviate the economic losses.

Respiratory Health in Migrant Populations: A Crisis Overlooked

Science.gov (United States)

Holguin, Fernando; Moughrabieh, M. Anas; Ojeda, Victoria; Patel, Sanjay R.; Peyrani, Paula; Pinedo, Miguel; Celedón, Juan C.; Douglas, Ivor S.; Upson, Dona J.

2017-01-01

The crisis in the Middle East has raised awareness about the challenges encountered by migrant populations, in particular, health-care access and delivery. Similar challenges are encountered by migrant populations around the world, including those entering the United States as refugees and/or survivors of torture as well as Mexicans and other Latin Americans crossing the border. During the 2016 International American Thoracic Society Meeting held in San Francisco, California, a group of researchers and health-care providers discussed these challenges at a minisymposium devoted to the respiratory health of migrants. The discussion focused on the increased incidence of airway diseases among individuals migrating to more developed countries, the problems created by sleep disorders and their implications for cardiovascular and mental health, the challenges inherent in the control of infections in refugee populations, and the problems resulting from deportation. The group also discussed the potential impact of novel strategies made available by Internet-based technologies and how these strategies could be deployed to support worldwide efforts in assisting migrants and refugees, even in countries that find themselves in the direst circumstances. These presentations are summarized in this document, which is not meant to be exhaustive, but to improve awareness about the challenges confronted by migrants and their host nations regarding respiratory health-care access and delivery, and about the need for adequate investment of resources to better define these challenges through research and for the development of efficient strategies for intervention. PMID:28146384

Thomas L Petty's lessons for the respiratory care clinician of today.

Science.gov (United States)

Pierson, David J

2014-08-01

Because of the importance of his original contributions and their practical relevance today, Thomas L Petty (1932-2009) was arguably the most important physician in the history of respiratory care. As much as any single individual, he was responsible for the concept of intensive and multidisciplinary respiratory care. In the 1960s and 1970s, he made key observations and introduced pioneering therapies in the ICU and in the home. He was the first to describe and name ARDS and to show how to use PEEP to treat life-threatening hypoxemia. He was one of the first anywhere to organize a pulmonary rehabilitation program and to show the beneficial effects of long-term oxygen therapy in COPD. Dr Petty emphasized the importance of practical, hands-on respiratory care education for both physicians and non-physicians using a collaborative team approach. He targeted educational activities and practical resources specifically to patients, and he showed how researchers and clinicians could interact responsibly with innovators in industry to the benefit of both. His life and career provide 6 important lessons for respiratory clinicians today and in the future: (1) whatever their roles, RTs and other clinicians in this field need to be experts in its core areas, such as mechanical ventilation, ARDS, and COPD; (2) respiratory care is a team activity: every member is important, and all the members need to communicate well and work together; (3) education needs to be targeted to those in the best position to benefit the patient, including primary care providers and family members; (4) everyone in the field needs to understand the important role of the respiratory care industry and to deal with it responsibly; (5) it must never be forgotten that it is all about the patient; and (6) respiratory care should be exciting and fun. Copyright © 2014 by Daedalus Enterprises.

Air Pollution and Nonmalignant Respiratory Mortality in 16 Cohorts within the ESCAPE Project

DEFF Research Database (Denmark)

Dimakopoulou, Konstantina; Samoli, Evangelia; Beelen, Rob

2014-01-01

Rationale: Prospective cohort studies have shown that chronic exposure to particulate matter and traffic related air pollution is associated with reduced survival. However, the effects on non-malignant respiratory mortality are less studied and those reported are less consistent. Objectives: We...... have investigated the relationship of long-term exposure to air pollution and non-malignant respiratory mortality in 16 cohorts with individual level data within the multi center European Study of Cohorts for Air Pollution Effects (ESCAPE). Methods: Data from 16 ongoing cohort studies from Europe were...... used. The total number of subjects was 307,553. There were 1,559 respiratory deaths during follow-up. Measurements: Air pollution exposure was estimated by land use regression models at the baseline residential addresses of study participants and traffic-proximity variables were derived from...

Systemic dermatitis and obstructive respiratory syndrome following occupational sensitization to trichloroethylene.

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Raşcu, Agripina; Bucur, Letiţia; Naghi, Eugenia; Drăghici, B

2003-01-01

We present a derma-respiratory syndrome in a patient occupationally exposed to trichloroethylene (TCE). At the beginning of its industrial use trichloroethylene was considered harmless. But, in time it showed a high noxious capacity. It produces an important and various pathology, which evolves as acute or chronic disease. The case we present shows that trichloroethylene can induce cutaneous pathology that excels contact dermatitis. It also proves that trichloroethylene can produce systemic effects (obstructive respiratory syndrome). The particularity of the case is based on the succession of the events, first the cutaneous and then the respiratory effects. A long period of time was necessary for the installation of the symptoms (for cutaneous and bronchial sensitization to take place). The case presented is the proof that trichloroethylene's great toxicity cannot be doubted and that the clinical forms due to sensitization to trichloroethylene can be dramatic.

Experience of Acute Respiratory Infections Treatment in Children with Combination Drug Askoril

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S.A. Kramarev

2015-05-01

Full Text Available Respiratory diseases are mostly accompanied by changes of mucociliary clearance. The paper presents the possibility of using combination preparation with different points of application for the treatment of tracheobronchial drainage disturbances in respiratory diseases in children.

 Methods of detection of selected respiratory viruses

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Ilona Stefańska

2012-06-01

Full Text Available  Respiratory viruses contribute to significant morbidity and mortality in healthy and immunocompromised individuals and are considered as a significant economic burden in the healthcare system. The similar clinical symptoms in the course of different viral and bacterial respiratory infections make the proper diagnosis difficult. An accurate and prompt diagnostics is crucial for infection control and patient management decisions, especially regarding the use of antibacterial or antiviral therapy and hospitalization. Moreover, the identification of the causative agent eliminates inappropriate use of antibiotics and may reduce the cost of healthcare.A wide variety of diagnostic procedures is applied for the detection of viral agents responsible for respiratory tract infections. For many years, the viral antigen detection and standard isolation technique in cell culture was the main method used in routine diagnostics. However, in recent years the nucleic acid amplification techniques have become widely used and have significantly improved the sensitivity of viral detection in clinical specimens. Molecular diagnostic assays have contributed to revealing high rates of co-infection (multiplex reactions and allow identification of agents that are difficult to culture.This paper discusses a number of technical aspects of the current most commonly used techniques, their general principles, main benefits and diagnostic value, but also some of their limitations.

Respiratory effort from the photoplethysmogram.

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Addison, Paul S

2017-03-01

The potential for a simple, non-invasive measure of respiratory effort based on the pulse oximeter signal - the photoplethysmogram or 'pleth' - was investigated in a pilot study. Several parameters were developed based on a variety of manifestations of respiratory effort in the signal, including modulation changes in amplitude, baseline, frequency and pulse transit times, as well as distinct baseline signal shifts. Thirteen candidate parameters were investigated using data from healthy volunteers. Each volunteer underwent a series of controlled respiratory effort maneuvers at various set flow resistances and respiratory rates. Six oximeter probes were tested at various body sites. In all, over three thousand pleth-based effort-airway pressure (EP) curves were generated across the various airway constrictions, respiratory efforts, respiratory rates, subjects, probe sites, and the candidate parameters considered. Regression analysis was performed to determine the existence of positive monotonic relationships between the respiratory effort parameters and resulting airway pressures. Six of the candidate parameters investigated exhibited a distinct positive relationship (poximeter probe and an ECG (P2E-Effort) and the other using two pulse oximeter probes placed at different peripheral body sites (P2-Effort); and baseline shifts in heart rate, (BL-HR-Effort). In conclusion, a clear monotonic relationship was found between several pleth-based parameters and imposed respiratory loadings at the mouth across a range of respiratory rates and flow constrictions. The results suggest that the pleth may provide a measure of changing upper airway dynamics indicative of the effort to breathe. Copyright © 2017 The Author. Published by Elsevier Ltd.. All rights reserved.

Is Previous Respiratory Disease a Risk Factor for Lung Cancer?

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

2014-01-01

Rationale: Previous respiratory diseases have been associated with increased risk of lung cancer. Respiratory conditions often co-occur and few studies have investigated multiple conditions simultaneously. Objectives: Investigate lung cancer risk associated with chronic bronchitis, emphysema, tuberculosis, pneumonia, and asthma. Methods: The SYNERGY project pooled information on previous respiratory diseases from 12,739 case subjects and 14,945 control subjects from 7 case–control studies conducted in Europe and Canada. Multivariate logistic regression models were used to investigate the relationship between individual diseases adjusting for co-occurring conditions, and patterns of respiratory disease diagnoses and lung cancer. Analyses were stratified by sex, and adjusted for age, center, ever-employed in a high-risk occupation, education, smoking status, cigarette pack-years, and time since quitting smoking. Measurements and Main Results: Chronic bronchitis and emphysema were positively associated with lung cancer, after accounting for other respiratory diseases and smoking (e.g., in men: odds ratio [OR], 1.33; 95% confidence interval [CI], 1.20–1.48 and OR, 1.50; 95% CI, 1.21–1.87, respectively). A positive relationship was observed between lung cancer and pneumonia diagnosed 2 years or less before lung cancer (OR, 3.31; 95% CI, 2.33–4.70 for men), but not longer. Co-occurrence of chronic bronchitis and emphysema and/or pneumonia had a stronger positive association with lung cancer than chronic bronchitis “only.” Asthma had an inverse association with lung cancer, the association being stronger with an asthma diagnosis 5 years or more before lung cancer compared with shorter. Conclusions: Findings from this large international case–control consortium indicate that after accounting for co-occurring respiratory diseases, chronic bronchitis and emphysema continue to have a positive association with lung cancer. PMID:25054566

Effect of respiratory function training on respiratory function of patients with severe cerebrovascular disease

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Ming GUO

2017-07-01

Full Text Available Objective To investigate the effect of respiratory function training on respiratory function and conscious state of patients with severe cerebrovascular disease (SCVD.  Methods A total of 27 patients with SCVD were divided into control group (N = 17 and observation group (N = 10. Control group received routine drug and rehabilitation treatment, and observation group was added respiratory function training based on routine treatment. The respiratory rate, tidal volume (TV, heart rate, blood pressure and artery oxygen saturation (SaO2 of patients were monitored by breathing machine before and after 4-week treatment. Meanwhile, arterial blood gas analysis was used to detect arterial partial pressure of oxygen (PaO2, oxygenation index, partial pressure of carbon dioxide (PaCO2 and pH value. At the same time, Glasgow Coma Scale (GCS was used to evaluate the conscious state of patients.  Results All patients successfully completed 4-week rehabilitation training, without asphyxia, arrhythmia or other adverse events. Compared with before training, the respiratory rate (P = 0.006 and pH value (P = 0.010 were significantly decreased, while SaO2 (P = 0.001, oxygenation index (P = 0.000 and GCS scores (P = 0.004, 0.017 were significantly increased in both groups of patients after training. There was no statistically significant difference between 2 groups on respiratory function indexes and GCS scores after training (P > 0.05, for all. Conclusions Respiratory function training did not significantly improve the respiratory function and conscious state of patients with SCVD, yet to be further studied. Randomized controlled clinical trials with larger, layered samples and long-term prognosis observation are needed. Examination method of respiratory function of SCVD patients is also a topic to be explored.  DOI: 10.3969/j.issn.1672-6731.2017.04.007

Influenza hospitalization epidemiology from a severe acute respiratory infection surveillance system in Jordan, January 2008?February 2014

OpenAIRE

Al?Abdallat, Mohammad; Dawson, Patrick; Haddadin, Aktham Jeries; El?Shoubary, Waleed; Dueger, Erica; Al?Sanouri, Tarek; Said, Mayar M.; Talaat, Maha

2016-01-01

Background Acute respiratory infections (ARIs) are a major cause of morbidity and mortality worldwide. Influenza typically contributes substantially to the burden of ARI, but only limited data are available on influenza activity and seasonality in Jordan. Methods Syndromic case definitions were used to identify individuals with severe acute respiratory infections (SARI) admitted to four sentinel hospitals in Jordan. Demographic and clinical data were collected. Nasopharyngeal and oropharyngea...

Microbial flora variations in the respiratory tract of mice

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Rosa Cangemi de Gutierrez

1999-09-01

Full Text Available A stable microbial system in the respiratory tract acts as an important defense mechanism against pathogenic microorganisms. Perturbations in this system may allow pathogens to establish. In an ecological environment such as the respiratory tract, there are many diverse factors that play a role in the establishment of the indigenous flora. In the present work we studied the normal microbial flora of different areas of the respiratory tract of mice and their evolution from the time the mice were born. Our interest was to know which were the dominant groups of microorganisms in each area, which were the first capable of colonizing and which dominated over time to be used as probiotic microorganisms. Our results show that Gram negative facultatively anaerobic bacilli and strict anaerobic microorganisms were the last ones to appear in the bronchia, while aerobic and Gram positive cocci were present in all the areas of the respiratory tract. The number of facultative aerobes and strict anaerobes were similar in the nasal passage, pharynx instilled and trachea, but lower in bronchia. The dominant species were Streptococcus viridans and Staphylococcus saprophyticcus, followed by S. epidermidis, Lactobacilli and S. cohnii I which were present on every studied days but at different proportions. This paper is the first part of a research topic investigating the protective effect of the indigenous flora against pathogens using the mice as an experimental model.

Respiratory Epithelium Lined Cyst of the Maxilla: Differential Diagnosis

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C. P. Martinelli-Kläy

2017-01-01

Full Text Available Maxillary cysts, including the cysts lined by respiratory epithelium, can present a diagnostic challenge. We report an unusual case of a maxillary cyst on an endodontically treated tooth #16, in which the cavity was totally lined by a respiratory epithelium. The patient, a 35-year-old male, presented with a generalized chronic periodontitis and complained of a pain in the tooth #16 region. A periodontal pocket extending to the root apices with pus coming out from the gingival was found. A combined endodontic periodontal was observed on a panoramic radiography. CBCT-scan revealed a well-circumscribed radiolucent lesion at the apices of the distobuccal root of the 16. A communication with the right maxillary sinus cavity and a maxillary and ethmoidal sinusitis were also observed. The lesion was removed and histological examination revealed a cyst lined exclusively by respiratory epithelium. Ciliated and rare mucous cells were also observed. The diagnosis could evoke a surgical ciliated cyst mimicking the radicular cyst but the patient has no previous history of trauma or surgery in the maxillofacial region. It could also be an unusual radicular cyst in which the stratified squamous epithelium was destroyed by inflammation and replaced by a respiratory epithelium of the maxillary sinus.

Measuring the impact of air pollution on respiratory infection risk in China

International Nuclear Information System (INIS)

Tang, Sanyi; Yan, Qinling; Shi, Wei; Wang, Xia; Sun, Xiaodan; Yu, Pengbo; Wu, Jianhong; Xiao, Yanni

2018-01-01

China is now experiencing major public health challenges caused by air pollution. Few studies have quantified the dynamics of air pollution and its impact on the risk of respiratory infection. We conducted an integrated data analysis to quantify the association among air quality index (AQI), meteorological variables and respiratory infection risk in Shaanxi province of China in the period of November 15th, 2010 to November 14th, 2016. Our analysis illustrated a statistically significantly positive correlation between the number of influenza-like illness (ILI) cases and AQI, and the respiratory infection risk has increased progressively with increased AQI with a time lag of 0–3 days. We also developed mathematical models for the AQI trend and respiratory infection dynamics, incorporating AQI-dependent incidence and AQI-based behaviour change interventions. Our combined data and modelling analysis estimated the basic reproduction number for the respiratory infection during the studying period to be 2.4076, higher than the basic reproduction number of the 2009 pandemic influenza in the same province. Our modelling-based simulations concluded that, in terms of respiratory infection risk reduction, the persistent control of emission in the China's blue-sky programme is much more effective than substantial social-economic interventions implemented only during the smog days. - Highlights: • Quantify the dynamics of air pollution, evaluate impact on respiratory infection. • Present a novel methodology through integrating statistic and dynamic models. • The respiratory infection risk has increased with increased air quality index. • Persistent control of emission in China's blue-sky program is much more effective. - This study presented a novel methodology to quantify the dynamics of air pollution and evaluate its impact of on the risk of respiratory infection, and hence to suggest interventions for China's blue-sky programme.

Enhancing ejection fraction measurement through 4D respiratory motion compensation in cardiac PET imaging

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Tang, Jing; Wang, Xinhui; Gao, Xiangzhen; Segars, W. Paul; Lodge, Martin A.; Rahmim, Arman

2017-06-01

ECG gated cardiac PET imaging measures functional parameters such as left ventricle (LV) ejection fraction (EF), providing diagnostic and prognostic information for management of patients with coronary artery disease (CAD). Respiratory motion degrades spatial resolution and affects the accuracy in measuring the LV volumes for EF calculation. The goal of this study is to systematically investigate the effect of respiratory motion correction on the estimation of end-diastolic volume (EDV), end-systolic volume (ESV), and EF, especially on the separation of normal and abnormal EFs. We developed a respiratory motion incorporated 4D PET image reconstruction technique which uses all gated-frame data to acquire a motion-suppressed image. Using the standard XCAT phantom and two individual-specific volunteer XCAT phantoms, we simulated dual-gated myocardial perfusion imaging data for normally and abnormally beating hearts. With and without respiratory motion correction, we measured the EDV, ESV, and EF from the cardiac-gated reconstructed images. For all the phantoms, the estimated volumes increased and the biases significantly reduced with motion correction compared with those without. Furthermore, the improvement of ESV measurement in the abnormally beating heart led to better separation of normal and abnormal EFs. The simulation study demonstrated the significant effect of respiratory motion correction on cardiac imaging data with motion amplitude as small as 0.7 cm. The larger the motion amplitude the more improvement respiratory motion correction brought about on the EF measurement. Using data-driven respiratory gating, we also demonstrated the effect of respiratory motion correction on estimating the above functional parameters from list mode patient data. Respiratory motion correction has been shown to improve the accuracy of EF measurement in clinical cardiac PET imaging.

Noninvasive ventilation for patients in acute respiratory distress: an update [digest].

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Joshi, Nikita; Estes, Molly K; Shipley, Kayla; Lee, Hyun-Chul Danny; Zaurova, Milana

2017-02-22

Over the last 20 years, noninvasive ventilation (NIV) strategies have been used with increasing frequency. The ease of use of NIV makes it applicable to patients presenting in a variety of types of respiratory distress. In this review, the physiology of positive pressure ventilation is discussed, including indications, contraindications, and options for mask type and fit. Characteristics of patients who are most likely to benefit from NIV are reviewed, including those in respiratory distress from chronic obstructive pulmonary disease exacerbation and cardiogenic pulmonary edema. The literature for other respiratory pathologies where NIV may be used, such as in asthma exacerbation, pediatric patients, and community-acquired pneumonia, is also reviewed. Controversies and potential future applications of NIV are presented. [Points & Pearls is a digest of Emergency Medicine Practice].

33 CFR 142.39 - Respiratory protection.

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2010-07-01

... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Respiratory protection. 142.39... Respiratory protection. (a) Personnel in an atmosphere specified under ANSI Z88.2, requiring the use of respiratory protection equipment shall wear the type of respiratory protection equipment specified in ANSI Z88...

Seasonal variations of respiratory viruses detected from children with respiratory tract infections in Riyadh, Saudi Arabia.

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Albogami, Saad S; Alotaibi, Meshal R; Alsahli, Saud A; Masuadi, Emad; Alshaalan, Mohammad

ARTIs have a huge impact in health systems in which 20-30% of all hospital admissions and 30-60% of practitioner visits are related to respiratory tract infections. The aim of this study is to determine the prevalence, age distribution, and seasonal variation of respiratory viruses. This study was descriptive retrospective study in which all patients 14 years of age and below who presented with signs and symptoms of ARTIs between January 2013 and December 2014 and had respiratory specimen tested by direct immunofluorescence assays for viruses identification were included in the study. During that period, a total of 4611 patients who presented with ARTIs from January 2013 to December 2014 were investigated, viruses were detected in 1115 (24%). RSV was associated with 97.4% of the total viral pathogens. Viruses were detected throughout all the two years with a peak in winter; Dec (n: 265), Jan (n: 418), Feb (n: 218), and Mar (n: 109). Viral pathogens are very important cause of ARTIs in our region. RSV was the most common virus detected with the highest detection rate in children who are two years old and below. A multi-center surveillance with more sensitive detection methods like PCR may help to provide a comprehensive understanding of virus distribution in our area, which may contribute implant an effective prevention approach for each virus. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

[Measurement of the passive compliance of the total respiratory system in newborn after respiratory insufficiency for risk assessment of respiratory disorders during the first 6 month of life].

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Olechowski, Wiesław; Majorek-Olechowska, Bernadetta

2010-01-01

To evaluate the relationships between postnatal passive respiratory compliance (Crs) and development of respiratory disorders during the first 6 month of life in preterm and full-term infants after respiratory insufficiency. The purpose of this study was to investigate whether other relevant neonatal factors, like degree of prematurity, birth weigh, ventilatory conditions, sepsis, and respiratory disease severity affected this relationship. The passive respiratory compliance was measured by the single occlusion technique in 73 preterm infants after respiratory distress syndrome (RDS), 19 full-term infants after congenital pneumonia and 33 healthy full-term infants. Respiratory function measurements were performed by single occlusion technique, during natural sleep, after acute phase of illness, before discharge from neonatal department. Crs was significantly lower in premature newborns newborns who have suffered from a congenital pneumonia (p = 0.0411), than in healthy full-term newborn infants. Premature infants who have undergone sepsis have significantly decreased Crs in relationship with those who did not have this complication (p = 0.0334). Preterm newborns who have suffered pneumonia during treatment of RDS have significantly frequent respiratory problems during the first 6 month of age (p = 0.043). Full-term infants after congenital pneumonia have more but not significantly frequent respiratory problems than healthy term newborns (p = 0.055) in this period. Decreased neonatal Crs wasn't significantly related to respiratory disorders in age of 6 month of life. Prematurity under 36 week of gestational age, low birth weight and suffering from sepsis in premature infants significantly decreased Crs in newborn. Decreased neonatal Crs in premature and full term infants after respiratory insufficiency wasn't significantly related to respiratory disorders during first 6 month of life. This study has showed significantly increase of respiratory problems in this

Respiratory syncytial virus (RSV)

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RSV; Palivizumab; Respiratory syncytial virus immune globulin; Bronchiolitis - RSV ... Crowe JE. Respiratory syncytial virus. In: Kliegman RM, Stanton BF, St. Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics . 20th ...

Radiological features of lower respiratory infection by respiratory syncytial virus in infants and young children

International Nuclear Information System (INIS)

Kim, Woo Sun; Kim, In One; Yeon, Kyung Mo; Jang, Seong Hee; Lee, Hoan Jong

1992-01-01

Respiratory syncytial virus is the most common cause of lower respiratory infection (bronchiolitis and pneumonia) of infancy and early childhood. We analyzed clinical and radiological features of 76 patients with lower respiratory infections by respiratory syncytial virus, which were diagnosed by indirect immunofluorescent test or culture of nasal aspirate in Hep-2-cell monolayer, during the period of January- December, 1991. There were peaks of incidences in March-May and November- December, accounting for 87% of eases. Sixty-two cases (82%) were under 1 year of age. Fifty cases (66%) had underlying diseases. Major radiographical findings were overaeration (83%), parahilar peribronchial infiltrates (67%), segmental or subsegmental atelectasis (32%), and segmental or lobar consolidation (16%). In 15 cases (20%), overaeration was the only radiological findings. There was no evidence of pleural effusion or lymph node enlargement in all cases. By considering clinical features (symptoms, age, underlying diseases, epidemic seasons) in addition to the radiological findings, radiologists would be familiar with lower respiratory infection by respiratory syncytial virus. Air space consolidation, which is generally thought to represent bacterial pneumonia, is also observed not infrequently in respiratory syncytial virus infection

Metagenomic analysis of viral diversity in respiratory samples from patients with respiratory tract infections in Kuwait.

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Madi, Nada; Al-Nakib, Widad; Mustafa, Abu Salim; Habibi, Nazima

2018-03-01

A metagenomic approach based on target independent next-generation sequencing has become a known method for the detection of both known and novel viruses in clinical samples. This study aimed to use the metagenomic sequencing approach to characterize the viral diversity in respiratory samples from patients with respiratory tract infections. We have investigated 86 respiratory samples received from various hospitals in Kuwait between 2015 and 2016 for the diagnosis of respiratory tract infections. A metagenomic approach using the next-generation sequencer to characterize viruses was used. According to the metagenomic analysis, an average of 145, 019 reads were identified, and 2% of these reads were of viral origin. Also, metagenomic analysis of the viral sequences revealed many known respiratory viruses, which were detected in 30.2% of the clinical samples. Also, sequences of non-respiratory viruses were detected in 14% of the clinical samples, while sequences of non-human viruses were detected in 55.8% of the clinical samples. The average genome coverage of the viruses was 12% with the highest genome coverage of 99.2% for respiratory syncytial virus, and the lowest was 1% for torque teno midi virus 2. Our results showed 47.7% agreement between multiplex Real-Time PCR and metagenomics sequencing in the detection of respiratory viruses in the clinical samples. Though there are some difficulties in using this method to clinical samples such as specimen quality, these observations are indicative of the promising utility of the metagenomic sequencing approach for the identification of respiratory viruses in patients with respiratory tract infections. © 2017 Wiley Periodicals, Inc.

Is Overall Mortality the Right Composite Endpoint in Clinical Trials of Acute Respiratory Distress Syndrome?

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Villar, Jesús; Martínez, Domingo; Mosteiro, Fernando; Ambrós, Alfonso; Añón, José M; Ferrando, Carlos; Soler, Juan A; Montiel, Raquel; Vidal, Anxela; Conesa-Cayuela, Luís A; Blanco, Jesús; Arrojo, Regina; Solano, Rosario; Capilla, Lucía; Del Campo, Rafael; Civantos, Belén; Fernández, María Mar; Aldecoa, César; Parra, Laura; Gutiérrez, Andrea; Martínez-Jiménez, Chanel; González-Martín, Jesús M; Fernández, Rosa L; Kacmarek, Robert M

2018-06-01

Overall mortality in patients with acute respiratory distress syndrome is a composite endpoint because it includes death from multiple causes. In most acute respiratory distress syndrome trials, it is unknown whether reported deaths are due to acute respiratory distress syndrome or the underlying disease, unrelated to the specific intervention tested. We investigated the causes of death after contracting acute respiratory distress syndrome in a large cohort. A secondary analysis from three prospective, multicenter, observational studies. A network of multidisciplinary ICUs. We studied 778 patients with moderate-to-severe acute respiratory distress syndrome treated with lung-protective ventilation. None. We examined death in the ICU from individual causes. Overall ICU mortality was 38.8% (95% CI, 35.4-42.3). Causes of acute respiratory distress syndrome modified the risk of death. Twenty-three percent of deaths occurred from refractory hypoxemia due to nonresolving acute respiratory distress syndrome. Most patients died from causes unrelated to acute respiratory distress syndrome: 48.7% of nonsurvivors died from multisystem organ failure, and cancer or brain injury was involved in 37.1% of deaths. When quantifying the true burden of acute respiratory distress syndrome outcome, we identified 506 patients (65.0%) with one or more exclusion criteria for enrollment into current interventional trials. Overall ICU mortality of the "trial cohort" (21.3%) was markedly lower than the parent cohort (relative risk, 0.55; 95% CI, 0.43-0.70; p respiratory distress syndrome patients are not directly related to lung damage but to extrapulmonary multisystem organ failure. It would be challenging to prove that specific lung-directed therapies have an effect on overall survival.

Respiratory Issues in OI

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Respiratory Issues in Osteogenesis Imperfecta \\ Introduction The respiratory system’s job is to bring oxygen into the body and remove carbon dioxide, the waste product of breathing. Because oxygen is the fuel ...

Traumatic retropharyngeal emphysema as a cause for severe respiratory distress in a newborn

International Nuclear Information System (INIS)

Barlev, Dan M.; Nagourney, Beth A.; Saintonge, Ronald

2003-01-01

Traumatic injury to the pharynx or esophagus in a newborn from intubation or tube suctioning may have various presentations. Difficulty passing a gastric tube or feeding problems may erroneously suggest the diagnosis of esophageal atresia. Associated respiratory distress may be caused by pneumothorax or pleural effusion if the pleural space is entered. We report the case of a full-term newborn presenting with severe respiratory distress caused by a large retropharyngeal air collection resulting from hypopharyngeal perforation from prior intubation and suctioning. Chest abnormality, sufficient to account for the degree of respiratory distress, was not demonstrated. (orig.)

Nasally administered Lactobacillus rhamnosus strains differentially modulate respiratory antiviral immune responses and induce protection against respiratory syncytial virus infection.

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Tomosada, Yohsuke; Chiba, Eriko; Zelaya, Hortensia; Takahashi, Takuya; Tsukida, Kohichiro; Kitazawa, Haruki; Alvarez, Susana; Villena, Julio

2013-08-15

Some studies have shown that nasally administered immunobiotics had the potential to improve the outcome of influenza virus infection. However, the capacity of immunobiotics to improve protection against respiratory syncytial virus (RSV) infection was not investigated before. The aims of this study were: a) to evaluate whether the nasal administration of Lactobacillus rhamnosus CRL1505 (Lr05) and L. rhamnosus CRL1506 (Lr06) are able to improve respiratory antiviral defenses and beneficially modulate the immune response triggered by TLR3/RIG-I activation; b) to investigate whether viability of Lr05 or Lr06 is indispensable to modulate respiratory immunity and; c) to evaluate the capacity of Lr05 and Lr06 to improve the resistance of infant mice against RSV infection. Nasally administered Lr05 and Lr06 differentially modulated the TLR3/RIG-I-triggered antiviral respiratory immune response. Lr06 administration significantly modulated the production of IFN-α, IFN-β and IL-6 in the response to poly(I:C) challenge, while nasal priming with Lr05 was more effective to improve levels of IFN-γ and IL-10. Both viable Lr05 and Lr06 strains increased the resistance of infant mice to RSV infection while only heat-killed Lr05 showed a protective effect similar to those observed with viable strains. The present work demonstrated that nasal administration of immunobiotics is able to beneficially modulate the immune response triggered by TLR3/RIG-I activation in the respiratory tract and to increase the resistance of mice to the challenge with RSV. Comparative studies using two Lactobacillus rhamnosus strains of the same origin and with similar technological properties showed that each strain has an specific immunoregulatory effect in the respiratory tract and that they differentially modulate the immune response after poly(I:C) or RSV challenges, conferring different degree of protection and using distinct immune mechanisms. We also demonstrated in this work that it is possible

Scintigraphic Evaluation of Esophageal Motility and Gastroesophageal Reflux in Patients Presenting with Upper Respiratory Tract Symptoms

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Amalachandran, Jaykanth; Simon, Shelley; Elangoven, Indirani; Jain, Avani; Sivathapandi, Thangalakshmi

2018-01-01

Purpose of Study: The purpose is to evaluate the findings and utility of esophageal transit scintigraphy (ETS) and gastroesophageal reflux scintigraphy (GES) in patients presenting with upper respiratory tract (URT) symptoms suspected to be due to gastroesophageal reflux (GER) disease. Materials and Methods: Thirty patients aged between 19 and 60 years underwent nasopharyngolaryngoscopy (NPL), ETS, and GES. Correlation between GER, esophageal motility, and NPL was evaluated. Inclusion criteria include patients with recurrent URT symptoms such as chronic dry cough/hoarseness of voice and itching/foreign body sensation in throat. Those with typical gastrointestinal (GI) symptoms of GER, URT symptoms relieved by antibiotics, surgical intervention in abdomen, cardiac/hepatobiliary diseases, etc. were excluded from the study. Results: Significant correlation was found between GER and NPL in 28/30 patients. More the grade of reflux, more severe was the NPL findings. Two patients with Grade II reflux had normal NPL suggesting structural inflammatory changes due to acidic pH of refluxate which have not yet manifested or symptoms could be due to nonacid refluxate. Incidence of esophageal motility disorder was statistically significant in patients with GER disease (GERD). Patients who had symptoms, but no demonstrable GER showed delayed ET in supine position suggesting the presence of esophageal motility disorder even before GERD. Conclusion: GES demonstrated GER in patients presenting with URT symptoms without typical GI symptoms. ETS showed coexistence of esophageal motility disorder in most patients presenting with URT symptoms even without an associated reflux disease. We hypothesize that primary abnormal esophageal motility leads to delayed esophageal clearance and consequently to URT symptoms. Addition of ETS to GES is easily feasible with no significant additional cost, time, or radiation burden. PMID:29430111

Dual cardiac-respiratory gated PET: implementation and results from a feasibility study

International Nuclear Information System (INIS)

Martinez-Moeller, Axel; Zikic, Darko; Navab, Nassir; Botnar, Rene M.; Bundschuh, Ralph A.; Ziegler, Sibylle I.; Schwaiger, Markus; Nekolla, Stephan G.; Howe, William

2007-01-01

Spatial resolution in myocardial imaging is impaired by both cardiac and respiratory motion owing to motional blurring. We investigated the feasibility of a dual cardiac-respiratory gated positron emission tomography (PET) acquisition using a clinical PET/computer tomography (CT) scanner. We describe its implementation and present results on the respiratory motion observed. The correlation between diaphragmatic excursion measured by real-time magnetic resonance imaging (MRI) and the expansion of the chest measured with an elastic belt was studied in six subjects. PET list mode acquisitions were then performed in 12 patients, six of them injected with 13 N-ammonia and six with 18 F-FDG. In parallel, the ECG and respiratory signals of the patients were recorded and the list mode file correspondingly sorted using a dual gated approach. Respiratory motion of the heart was quantified by measuring the displacement between the inspiratory and expiratory images in the diastolic phase by means of intensity-based non-rigid image registration. The correlation between diaphragmatic excursion and expansion of the chest was excellent (R 2 = 0.91), validating the ability of the elastic belt to provide an adequate respiratory trigger. Respiratory signals corresponding to the chest expansion showed a large inter-patient variability, requiring adapted algorithms in order to define suitable respiratory gates. Dual gated PET series were successfully acquired for both groups of patients, showing better resolved myocardial walls. The average respiratory motion of the heart measured by PET was 4.8 mm, with its largest component in the craniocaudal direction. Moreover, a deformation of the heart with respiration was observed, with the inferior wall moving significantly more than the anterior. Dual gated cardiac PET studies were performed successfully and showed better resolved myocardial walls as compared with ungated acquisitions. The respiratory motion of the heart presented a

Endocan and the respiratory system: a review

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Kechagia M

2016-12-01

Full Text Available Maria Kechagia,1,2 Ioannis Papassotiriou,2 Konstantinos I Gourgoulianis1 1Respiratory Medicine Department, University of Thessaly Medical School, Larissa, 2Department of Clinical Biochemistry, Aghia Sophia Children’s Hospital, Athens, Greece Abstract: Endocan, formerly called endothelial cell-specific molecule 1, is an endothelial cell-associated proteoglycan that is preferentially expressed by renal and pulmonary endothelium. It is upregulated by proangiogenic molecules as well as by pro-inflammatory cytokines, and since it reflects endothelial activation and dysfunction, it is regarded as a novel tissue and blood-based relevant biomarker. As such, it is increasingly being researched and evaluated in a wide spectrum of healthy and disease pathophysiological processes. Here, we review the present scientific knowledge on endocan, with emphasis on the evidence that underlines its possible clinical value as a prognostic marker in several malignant, inflammatory and obstructive disorders of the respiratory system. Keywords: endocan, endothelial dysfunction, inflammation, respiratory disorders

AIR POLLUTION FROM TRAFFIC AND RESPIRATORY HEALTH

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Maja Nikolić

2004-12-01

Full Text Available Air pollution has very important influence on human health. Earlier investigations were not employed with estimation of influence of air pollution, which spring from traffic, on people health who live near busy cross – road.The aim of this paper was to determine how living near busy cross – road influences on appearance of respiratory symptoms and illness.400 adult people between 18-76 age who live five year least on this location at took a part in investigation. One group (200 live in Nis near the busiest cross-road, another group live in Niska Banja near cross-road with the smallest concentration of pollutants in last five years.We have determined that examines, who live near busy cross – road had statistical signify greater prevalence of all respiratory symptoms and pneumonia.Our investigation showed that living near busy cross road present risk factor for appearance of respiratory symptoms and pneumonia.

Acute respiratory distress syndrome

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... page: //medlineplus.gov/ency/article/000103.htm Acute respiratory distress syndrome To use the sharing features on this page, please enable JavaScript. Acute respiratory distress syndrome (ARDS) is a life-threatening lung ...

Increased release of histamine in patients with respiratory symptoms related to perfume.

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Elberling, J; Skov, P S; Mosbech, H; Holst, H; Dirksen, A; Johansen, J D

2007-11-01

Environmental perfume exposure may cause respiratory symptoms. Individuals with asthma and perfume contact allergy report such symptoms more frequently than others. However, immunologic mechanisms have not been demonstrated and the symptoms are not associated with IgE-mediated allergy. The study aimed to investigate whether basophils from patients with respiratory symptoms related to perfume released more histamine in the presence of perfume as compared with healthy volunteers. Histamine release was measured by the glass fibre method. Blood was obtained from healthy volunteers (n=20) and patients with respiratory symptoms related to perfume (n=17) attending a dermatological outpatient clinic for patch testing. The effect of an international brand perfume was investigated using the basophil histamine release test with perfume. Furthermore, basophils from a healthy non-atopic donor were incubated with participant's sera and histamine release induced by perfume was measured. In both groups incremental perfume concentrations showed a positive and significant (Pperfume concentration, the basophils released significantly (PPerfume induces a dose-dependent non-IgE-mediated release of histamine from human peripheral blood basophils. Increased basophil reactivity to perfume was found in patients with respiratory symptoms related to perfume.

ERS/ATS workshop report on respiratory health effects of household air pollution.

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Sood, Akshay; Assad, Nour A; Barnes, Peter J; Churg, Andrew; Gordon, Stephen B; Harrod, Kevin S; Irshad, Hammad; Kurmi, Om P; Martin, William J; Meek, Paula; Mortimer, Kevin; Noonan, Curtis W; Perez-Padilla, Rogelio; Smith, Kirk R; Tesfaigzi, Yohannes; Ward, Tony; Balmes, John

2018-01-01

Exposure to household air pollution (HAP) from solid fuel combustion affects almost half of the world population. Adverse respiratory outcomes such as respiratory infections, impaired lung growth and chronic obstructive pulmonary disease have been linked to HAP exposure. Solid fuel smoke is a heterogeneous mixture of various gases and particulates. Cell culture and animal studies with controlled exposure conditions and genetic homogeneity provide important insights into HAP mechanisms. Impaired bacterial phagocytosis in exposed human alveolar macrophages possibly mediates several HAP-related health effects. Lung pathological findings in HAP-exposed individuals demonstrate greater small airways fibrosis and less emphysema compared with cigarette smokers. Field studies using questionnaires, air pollution monitoring and/or biomarkers are needed to better establish human risks. Some, but not all, studies suggest that improving cookstove efficiency or venting emissions may be associated with reduced respiratory symptoms, lung function decline in women and severe pneumonia in children. Current studies focus on fuel switching, stove technology replacements or upgrades and air filter devices. Several governments have initiated major programmes to accelerate the upgrade from solid fuels to clean fuels, particularly liquid petroleum gas, which provides research opportunities for the respiratory health community. Copyright ©ERS 2018.

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

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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.

Quasispecies variation of porcine reproductive and respiratory syndrome virus during natural infection

International Nuclear Information System (INIS)

Goldberg, Tony L.; Lowe, James F.; Milburn, Suzanne M.; Firkins, Lawrence D.

2003-01-01

Porcine reproductive and respiratory syndrome virus (PRRSV) displays notorious genetic, antigenic, and clinical variability. Little is known, however, about the nature and extent of viral variation present within naturally infected animals. By amplifying and cloning the open reading frame 5 gene from tonsils of naturally infected swine, and by sequencing individual clones, we characterized viral diversity in nine animals from two farms. All animals harbored multiple PRRSV variants at both the nucleic and the amino acid levels. Structural variation and rates of synonymous and nonsynonymous nucleotide substitution were no different within known epitopes than elsewhere. Analysis of molecular variance indicated that differences between farms, among animals within farms, and within individual animals accounted for 92.94, 3.84, and 3.22% of the total viral genetic variability observed, respectively. PRRSV exists during natural infection as a quasispecies distribution of related genotypes. Positive natural selection for immune evasiveness does not appear to maintain this diversity

Upper respiratory tract (image)

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The major passages and structures of the upper respiratory tract include the nose or nostrils, nasal cavity, mouth, throat (pharynx), and voice box (larynx). The respiratory system is lined with a mucous membrane that ...

Respiratory cancer database: An open access database of respiratory cancer gene and miRNA.

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Choubey, Jyotsna; Choudhari, Jyoti Kant; Patel, Ashish; Verma, Mukesh Kumar

2017-01-01

Respiratory cancer database (RespCanDB) is a genomic and proteomic database of cancer of respiratory organ. It also includes the information of medicinal plants used for the treatment of various respiratory cancers with structure of its active constituents as well as pharmacological and chemical information of drug associated with various respiratory cancers. Data in RespCanDB has been manually collected from published research article and from other databases. Data has been integrated using MySQL an object-relational database management system. MySQL manages all data in the back-end and provides commands to retrieve and store the data into the database. The web interface of database has been built in ASP. RespCanDB is expected to contribute to the understanding of scientific community regarding respiratory cancer biology as well as developments of new way of diagnosing and treating respiratory cancer. Currently, the database consist the oncogenomic information of lung cancer, laryngeal cancer, and nasopharyngeal cancer. Data for other cancers, such as oral and tracheal cancers, will be added in the near future. The URL of RespCanDB is http://ridb.subdic-bioinformatics-nitrr.in/.

A Review on Human Respiratory Modeling.

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Ghafarian, Pardis; Jamaati, Hamidreza; Hashemian, Seyed Mohammadreza

2016-01-01

Input impedance of the respiratory system is measured by forced oscillation technique (FOT). Multiple prior studies have attempted to match the electromechanical models of the respiratory system to impedance data. Since the mechanical behavior of airways and the respiratory system as a whole are similar to an electrical circuit in a combination of series and parallel formats some theories were introduced according to this issue. It should be noted that, the number of elements used in these models might be less than those required due to the complexity of the pulmonary-chest wall anatomy. Various respiratory models have been proposed based on this idea in order to demonstrate and assess the different parts of respiratory system related to children and adults data. With regard to our knowledge, some of famous respiratory models in related to obstructive, restrictive diseases and also Acute Respiratory Distress Syndrome (ARDS) are reviewed in this article.

Respiratory symptoms and occupation: a cross-sectional study of the general population

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Smit Henriëtte A

2002-12-01

Full Text Available Abstract Background This study focused on respiratory symptoms due to occupational exposures in a contemporary general population cohort. Subjects were from the Dutch Monitoring Project on Risk Factors for Chronic Diseases (MORGEN. The composition of this population enabled estimation of respiratory risks due to occupation from the recent past for both men and women. Methods The study subjects (aged 20–59 were all inhabitants of Doetinchem, a small industrial town, and came from a survey of a random sample of 1104 persons conducted in 1993. A total of 274 cases with respiratory symptoms (subdivided in asthma and bronchitis symptoms and 274 controls without symptoms were matched for age and sex. Relations between industry and occupation and respiratory symptoms were explored and adjusted for smoking habits and social economic status. Results Employment in the 'construction' (OR = 3.38; 95%CI 1.02 – 11.27, 'metal' (OR = 3.17; 95%CI 0. 98 – 10.28, 'rubber, plastics and synthetics' (OR = 6.52; 95%CI 1.26 – 53.80, and 'printing' industry (OR = 3.96; 95%CI 0.85 – 18.48 were positively associated with chronic bronchitis symptoms. In addition, the 'metal' industry was found to be weakly associated with asthma symptoms (OR = 2.59; 95%CI 0.87 – 7.69. Duration of employment within these industries was also positively associated with respiratory symptoms. Conclusion Respiratory symptoms in the general population are traceable to employment in particular industries even in a contemporary cohort with relatively young individuals.

The burden of seasonal respiratory infections on a national telehealth service in England.

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Morbey, R A; Harcourt, S; Pebody, R; Zambon, M; Hutchison, J; Rutter, J; Thomas, H; Smith, G E; Elliot, A J

2017-07-01

Seasonal respiratory illnesses present a major burden on primary care services. We assessed the burden of respiratory illness on a national telehealth system in England and investigated the potential for providing early warning of respiratory infection. We compared weekly laboratory reports for respiratory pathogens with telehealth calls (NHS 111) between week 40 in 2013 and week 29 in 2015. Multiple linear regression was used to identify which pathogens had a significant association with respiratory calls. Children aged respiratory pathogens explained over 83% of the variation in cold/flu, cough and difficulty breathing calls. Based on the first two seasons available, the greatest burden was associated with respiratory syncytial virus (RSV) and influenza, with associations found in all age bands. The most sensitive signal for influenza was calls for 'cold/flu', whilst for RSV it was calls for cough. The best-fitting models showed calls increasing a week before laboratory specimen dates. Daily surveillance of these calls can provide early warning of seasonal rises in influenza and RSV, contributing to the national respiratory surveillance programme.

Avian respiratory system disorders

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Olsen, Glenn H.

1989-01-01

Diagnosing and treating respiratory diseases in avian species requires a basic knowledge about the anatomy and physiology of this system in birds. Differences between mammalian and avian respiratory system function, diagnosis, and treatment are highlighted.

EPIDEMIOLOGICAL AND CLINICAL FEATURES OF COMBINED RESPIRATORY INFECTIONS IN CHILDREN

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V. V. Shkarin

2017-01-01

Full Text Available Presents a review of publications on the problem of combined respiratory infections among children. Viral-bacterial associations are registered  in a group of often ill children in 51.7%. More than half of the patients have herpesvirus infection in various combinations. The presence of a combined acute respiratory viral infection among children in the group from 2 to 6 years was noted in 44.2% of cases, among which, in addition to influenza viruses, RS-, adeno-, etc., metapneumovirus and bocavirus plays an important role.The increase in severity of acute respiratory viral infection with combined  infection, with chlamydia  and mycoplasma infection is shown. A longer and more severe course of whooping cough was observed when combined with respiratory viruses.The revealed facts of frequency of distribution of combined  respiratory infections in children, the severity and duration of their course with the development of various complications and the formation of chronic pathology dictate the need to improve diagnosis and treatment tactics of these forms of infections.

The Effects of Air Pollution on Cardiovascular and Respiratory Causes of Emergency Admission.

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Shahi, Ali Mohammad; Omraninava, Ali; Goli, Mitra; Soheilarezoomand, Hamid Reza; Mirzaei, Nader

2014-01-01

Today, air pollution is one of the critical problems in metropolitans and necessary preparations are needed for confronting this crisis. The present study was based on the goal of determining the relationship of air pollutant levels with the rate of emergency admissions for respiratory and cardiovascular patients. In the present retrospective cross-sectional study, all respiratory and cardiovascular patients, referred to emergency department during 2012, were assessed. The meteorological and air pollution data were collected. Information regarding the numbers and dates (month, day) of admission for respiratory and cardiovascular diseases was achieved from the hospital's electronic registration system. The relation of air pollution and respiratory and cardiovascular admissions were analyzed by generalize additive model (GAM). 5922 patients were assessed which included 4048 (68.36%) cardiovascular and 1874 (31.64%) respiratory. Carbon monoxide (CO) level was an independent risk factor of cardiovascular disease on the same day (RR=1.49; 95% CI: 1.25- 1.77; Prespiratory admissions. The increased level of particulate matter less than 2.5 micrometers in diameter (PM2.5) like O3 led to growth in the admissions to emergency department. The findings of the present study suggested that rising levels of CO and O3 during two days leads to a significant increase in cardiovascular admission on the third day. Furthermore, increase in O3, PM2.5, nitrogen dioxide (NO2), and CO levels causes a rise in respiratory admissions to emergency department.

Effects of Aerobic Exercise on the Pulmonary Functions, Respiratory Symptoms and Psychological Status of People Living With HIV.

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Aweto, Happiness Anulika; Aiyegbusi, Ayoola Ibifubara; Ugonabo, Adaora Justina; Adeyemo, Titilope Adenike

2016-01-01

Pulmonary complications, respiratory symptoms and depression are common occurrences which contribute to the morbidity and mortality seen in individuals living with HIV/AIDS. This study investigated the effect of aerobic exercise on the pulmonary functions, respiratory symptoms and psychological status of people living with HIV. This study was conducted in Lagos, Nigeria from October 2014 to May 2015. Forty eligible individuals with HIV aged 18 yr and above participated, of which 33 cooperated to the end. They were recruited from the HIV/AIDS Prevention and Intervention Initiative (APIN) Clinic, Lagos University Teaching Hospital, Nigeria and were randomly assigned to either the study or the control group. The study group received aerobic exercise training three times a week for six weeks and counselling while the control group received only counselling. Pulmonary functions, respiratory symptoms and psychological status were evaluated at baseline and at six weeks. Inferential statistics of paired and independent t-test were used to analyse the data. Comparison of mean changes in the pulmonary variables of the study group with those of the control group showed significant differences in all but in the respiratory rate (RR) - [Forced Expiratory Volume in one second: P=0.001, Forced Vital Capacity: P=0.001, Peak Expiratory Flow: P=0.001]. There were also significant differences between the mean changes in respiratory symptoms (P=0.001) and depressive symptoms (P=0.001) of study group and those of the control group. Aerobic exercise training significantly improved pulmonary functions as well as significantly reduced respiratory and depressive symptoms in people living with HIV.

Assessing the effects of pharmacological agents on respiratory dynamics using time-series modeling.

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Wong, Kin Foon Kevin; Gong, Jen J; Cotten, Joseph F; Solt, Ken; Brown, Emery N

2013-04-01

Developing quantitative descriptions of how stimulant and depressant drugs affect the respiratory system is an important focus in medical research. Respiratory variables-respiratory rate, tidal volume, and end tidal carbon dioxide-have prominent temporal dynamics that make it inappropriate to use standard hypothesis-testing methods that assume independent observations to assess the effects of these pharmacological agents. We present a polynomial signal plus autoregressive noise model for analysis of continuously recorded respiratory variables. We use a cyclic descent algorithm to maximize the conditional log likelihood of the parameters and the corrected Akaike's information criterion to choose simultaneously the orders of the polynomial and the autoregressive models. In an analysis of respiratory rates recorded from anesthetized rats before and after administration of the respiratory stimulant methylphenidate, we use the model to construct within-animal z-tests of the drug effect that take account of the time-varying nature of the mean respiratory rate and the serial dependence in rate measurements. We correct for the effect of model lack-of-fit on our inferences by also computing bootstrap confidence intervals for the average difference in respiratory rate pre- and postmethylphenidate treatment. Our time-series modeling quantifies within each animal the substantial increase in mean respiratory rate and respiratory dynamics following methylphenidate administration. This paradigm can be readily adapted to analyze the dynamics of other respiratory variables before and after pharmacologic treatments.

Fluctuations and Noise in Stochastic Spread of Respiratory Infection Epidemics in Social Networks

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Yulmetyev, Renat; Emelyanova, Natalya; Demin, Sergey; Gafarov, Fail; Hänggi, Peter; Yulmetyeva, Dinara

2003-05-01

For the analysis of epidemic and disease dynamics complexity, it is necessary to understand the basic principles and notions of its spreading in long-time memory media. Here we considering the problem from a theoretical and practical viewpoint, presenting the quantitative evidence confirming the existence of stochastic long-range memory and robust chaos in a real time series of respiratory infections of human upper respiratory track. In this work we present a new statistical method of analyzing the spread of grippe and acute respiratory track infections epidemic process of human upper respiratory track by means of the theory of discrete non-Markov stochastic processes. We use the results of our recent theory (Phys. Rev. E 65, 046107 (2002)) for the study of statistical effects of memory in real data series, describing the epidemic dynamics of human acute respiratory track infections and grippe. The obtained results testify to an opportunity of the strict quantitative description of the regular and stochastic components in epidemic dynamics of social networks with a view to time discreteness and effects of statistical memory.

Multiplexed salivary protein profiling for patients with respiratory diseases using fiber-optic bundles and fluorescent antibody-based microarrays.

Science.gov (United States)

Nie, Shuai; Benito-Peña, Elena; Zhang, Huaibin; Wu, Yue; Walt, David R

2013-10-01

Over the past 40 years, the incidence and prevalence of respiratory diseases have increased significantly throughout the world, damaging economic productivity and challenging health care systems. Current diagnoses of different respiratory diseases generally involve invasive sampling methods such as induced sputum or bronchoalveolar lavage that are uncomfortable, or even painful, for the patient. In this paper, we present a platform incorporating fiber-optic bundles and antibody-based microarrays to perform multiplexed protein profiling of a panel of six salivary biomarkers for asthma and cystic fibrosis (CF) diagnosis. The platform utilizes an optical fiber bundle containing approximately 50,000 individual 4.5 μm diameter fibers that are chemically etched to create microwells in which modified microspheres decorated with monoclonal capture antibodies can be deposited. On the basis of a sandwich immunoassay format, the array quantifies human vascular endothelial growth factor (VEGF), interferon gamma-induced protein 10 (IP-10), interleukin-8 (IL-8), epidermal growth factor (EGF), matrix metalloproteinase 9 (MMP-9), and interleukin-1 beta (IL-1β) salivary biomarkers in the subpicomolar range. Saliva supernatants collected from 291 individuals (164 asthmatics, 71 CF patients, and 56 healthy controls (HC)) were analyzed on the platform to profile each group of patients using this six-analyte suite. It was found that four of the six proteins were observed to be significantly elevated (p < 0.01) in asthma and CF patients compared with HC. These results demonstrate the potential to use the multiplexed protein array platform for respiratory disease diagnosis.

Recurrent Acute Respiratory Infections in Children: Effectiveness and Safety of Phytotherapy

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V. P. Vavilova

2015-01-01

Full Text Available Recurrent respiratory infections in children lead to physical development disorders, formation of chronic nidi of infection, failure of adaptive mechanisms and degradation o immunobiological resisting barriers; this causes development of new diseases. Results of the presented non interventional clinical study confirm high safety profile and effectiveness of a therapeutic phytopreparation for recurrent respiratory infections. 

A 15-Month-Old Boy With Respiratory Distress and Parapharyngeal Abscess: A Case Report

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Behdad Gharib

2017-01-01

Full Text Available Parapharyngeal abscess is a life-threatening disease. Upper respiratory tract infection is the main cause in children. We present a 15-month-old boy admitted to the emergency ward with the chief complaint of difficulty in breathing caused by parapharyngealabscess. His condition deteriorated gradually, and he transferred to the operation theater quickly for abscess drainage and because of the difficulty in orotracheal intubation; a tracheostomy was performed. His respiratory condition deteriorated 2 days after PICU admission, and the medical team noticed an unexplainable respiratory distress. A chest x ray obtained and showed a right side pneumothorax and subcutaneous emphysema around theneck area. The case presented here, had not been diagnosed at the first examination; however, there were enough clinical clues (such as respiratory distress, drooling, torticollis, bulging of theneck, previous viral respiratory infection, possible pharyngeal trauma. The story of this case reminds us the importance of the precise physical exam and history taking which could be life-saving.

Management of Postoperative Respiratory Failure.

Science.gov (United States)

Mulligan, Michael S; Berfield, Kathleen S; Abbaszadeh, Ryan V

2015-11-01

Despite best efforts, postoperative complications such as postoperative respiratory failure may occur and prompt recognition of the process and management is required. Postoperative respiratory failure, such as postoperative pneumonia, postpneumonectomy pulmonary edema, acute respiratory distress-like syndromes, and pulmonary embolism, are associated with high morbidity and mortality. The causes of these complications are multifactorial and depend on preoperative, intraoperative, and postoperative factors, some of which are modifiable. The article identifies some of the risk factors, causes, and treatment strategies for successful management of the patient with postoperative respiratory failure. Copyright © 2015 Elsevier Inc. All rights reserved.

[The genetic component of chronic respiratory diseases in workers of foundry productions].

Science.gov (United States)

Loskutov, D V; Khamitova, R Ya

Review of the literature shows that currently there is an accumulation of data on the genetic determination of individual susceptibility to adverse industrial factors. Material of the research were high molecular DNA samples isolated from epithelial mouth scrapings in 99 foundry workers. Study of polymorphic variants of interleukin genes was performed by means of the analysis ofproducts of amplification of specific regions of the genome. Homozygous genotype TNF-a (-308A/G) was established to increase the relative risk of shaping of chronic respiratory diseases: with AA alleles - by 6.4 times and GG alleles - by 2.4 times, while the heterozygous genotype (AG) decreases - by 1. 9 times. Polymorphism of gene IL-1β (+3953 T / C) had no significance for the development of respiratory disease. Genotyping interleukins, involved in the inflammatory responses of the bronchopulmonary tract, can be considered as an element ofprimary prevention in industries with a high risk for shaping of respiratory diseases.

Respiratory monitoring with an acceleration sensor

International Nuclear Information System (INIS)

Ono, Tomohiro; Takegawa, Hideki; Ageishi, Tatsuya; Takashina, Masaaki; Numasaki, Hodaka; Matsumoto, Masao; Teshima, Teruki

2011-01-01

Respiratory gating radiotherapy is used to irradiate a local area and to reduce normal tissue toxicity. There are certain methods for the detection of tumor motions, for example, using internal markers or an external respiration signal. However, because some of these respiratory monitoring systems require special or expensive equipment, respiratory monitoring can usually be performed only in limited facilities. In this study, the feasibility of using an acceleration sensor for respiratory monitoring was evaluated. The respiratory motion was represented by means of a platform and measured five times with the iPod touch (registered) at 3, 4 and 5 s periods of five breathing cycles. For these three periods of the reference waveform, the absolute means ± standard deviation (SD) of displacement were 0.45 ± 0.34 mm, 0.33 ± 0.24 mm and 0.31 ± 0.23 mm, respectively. On the other hand, the corresponding absolute means ± SD for the periods were 0.04 ± 0.09 s, 0.04 ± 0.02 s and 0.06 ± 0.04 s. The accuracy of respiratory monitoring using the acceleration sensor was satisfactory in terms of the absolute means ± SD. Using the iPod touch (registered) for respiratory monitoring does not need special equipment and makes respiratory monitoring easier. For these reasons, this system is a viable alternative to other respiratory monitoring systems.

Physical activity and respiratory muscle strength in elderly: a systematic review

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Fabio Dutra Pereira

Full Text Available Introduction The aging will inevitably bring some kind of functional decline in elderly, sarcopenia in this sense stands out because it damages the muscle function and extend also to the respiratory muscles. Objective Systematically review studies that have sought to compare the strength of respiratory muscles between sedentary and physically active elderly in training programs nonspecific respiratory musculature. Materials and methods From the descriptors motor activity, respiratory muscles and elderly, the databases LILACS, MedLine, Cochrane, PEDro, Scirus and Redalyc were consulted. Results Of 1.263 experiments available in said databases, 12 were recovered and 6 were selected due they meet all the inclusion criteria and selection requirements. Conclusion Physical activity programs offered by the selected studies led physically active elderly to have respiratory muscle strength statistically higher than the sedentary. However, this condition did not expressed itself as security to these elderly to present strength levels above of the minimum predictive of normality.

Quantitation of respiratory viruses in relation to clinical course in children with acute respiratory tract infections

NARCIS (Netherlands)

Jansen, Rogier R.; Schinkel, Janke; dek, Irene; Koekkoek, Sylvie M.; Visser, Caroline E.; de Jong, Menno D.; Molenkamp, Richard; Pajkrt, Dasja

2010-01-01

Quantitation of respiratory viruses by PCR could potentially aid in clinical interpretation of PCR results. We conducted a study in children admitted with acute respiratory tract infections to study correlations between the clinical course of illness and semiquantitative detection of 14 respiratory

Cross-shift study of exposure-response relationships between bioaerosol exposure and respiratory effects in the Norwegian grain and animal feed production industry

NARCIS (Netherlands)

Straumfors, Anne; Heldal, Kari Kulvik; Eduard, Wijnand; Wouters, Inge M; Ellingsen, Dag G; Skogstad, Marit

2016-01-01

OBJECTIVE: We have studied cross-shift respiratory responses of several individual bioaerosol components of the dust in the grain and feed industry in Norway. METHODS: Cross-shift changes in lung function and nasal congestion, as well as in respiratory and systemic symptoms of 56 exposed workers and

MicroRNA Expression Profiling of Human Respiratory Epithelium Affected by Invasive Candida Infection.

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Syed Aun Muhammad

Full Text Available Invasive candidiasis is potentially life-threatening systemic fungal infection caused by Candida albicans (C. albicans. Candida enters the blood stream and disseminate throughout the body and it is often observed in hospitalized patients, immunocompromised individuals or those with chronic diseases. This infection is opportunistic and risk starts with the colonization of C. albicans on mucocutaneous surfaces and respiratory epithelium. MicroRNAs (miRNAs are small non-coding RNAs which are involved in the regulation of virtually every cellular process. They regulate and control the levels of mRNA stability and post-transcriptional gene expression. Aberrant expression of miRNAs has been associated in many disease states, and miRNA-based therapies are in progress. In this study, we investigated possible variations of miRNA expression profiles of respiratory epithelial cells infected by invasive Candida species. For this purpose, respiratory epithelial tissues of infected individuals from hospital laboratory were accessed before their treatment. Invasive Candida infection was confirmed by isolation of Candia albicans from the blood cultures of the same infected individuals. The purity of epithelial tissues was assessed by flow cytometry (FACSCalibur cytometer; BD Biosciences, Heidelberg, Germany using statin antibody (S-44. TaqMan quantitative real-time PCR (in a TaqMan Low Density Array format was used for miRNA expression profiling. MiRNAs investigated, the levels of expression of 55 miRNA were significantly altered in infected tissues. Some miRNAs showed dramatic increase (miR-16-1 or decrease of expression (miR-17-3p as compared to control. Gene ontology enrichment analysis of these miRNA-targeted genes suggests that Candidal infection affect many important biological pathways. In summary, disturbance in miRNA expression levels indicated the change in cascade of pathological processes and the regulation of respiratory epithelial functions

Leukocytes respiratory burst activity as indicator of innate immunity of pacu Piaractus mesopotamicus

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JD Biller-Takahashi

Full Text Available The present study evaluated the assay to quantify the respiratory burst activity of blood leukocytes of pacu as an indicator of the innate immune system, using the reduction of nitroblue tetrazolium (NBT to formazan as a measure of the production of reactive oxygen species (ROS. In order to assess the accuracy of the assay, fish were challenged by Aeromonas hydrophila and sampled one week after challenge. The A. hydrophila infection increased the leukocyte respiratory burst activity. The protocol showed a reliable and easy assay, appropriate to determine the respiratory burst activity of blood leukocytes of pacu, a neotropical fish, in the present experimental conditions.

Respiratory innate immune proteins differentially modulate the neutrophil respiratory burst response to influenza A virus

DEFF Research Database (Denmark)

White, Mitchell R; Crouch, Erika; Vesona, Jenny

2005-01-01

of IAV with SP-D in vitro strongly increases neutrophil respiratory burst responses to the virus. Several factors are shown to modify this apparent proinflammatory effect of SP-D. Although multimeric forms of SP-D show dose-dependent augmentation of respiratory burst responses, trimeric, single-arm forms...... of IAV while reducing the respiratory burst response to virus....

Respiratory health effects in relation to crystalline silica

CSIR Research Space (South Africa)

Hnizdo, E

1998-11-01

Full Text Available corresponding with the 5th percentile and the one-sided 95% confidence limits for different equations Table 3-4 Comparison between studies of occupational groups done on black men in South Africa in higher altitude Figure 3-1 Age distribution for white... of decreased reliability. 6 2.2 INTRODUCTION Screening for lung function impairment in subjects exposed to respiratory hazards should be able to identify those individuals whose lung function falls bellow predicted values, and those who demonstrate...

Effects of respiratory muscle work on respiratory and locomotor blood flow during exercise.

Science.gov (United States)

Dominelli, Paolo B; Archiza, Bruno; Ramsook, Andrew H; Mitchell, Reid A; Peters, Carli M; Molgat-Seon, Yannick; Henderson, William R; Koehle, Michael S; Boushel, Robert; Sheel, A William

2017-11-01

What is the central question of this study? Does manipulation of the work of breathing during high-intensity exercise alter respiratory and locomotor muscle blood flow? What is the main finding and its importance? We found that when the work of breathing was reduced during exercise, respiratory muscle blood flow decreased, while locomotor muscle blood flow increased. Conversely, when the work of breathing was increased, respiratory muscle blood flow increased, while locomotor muscle blood flow decreased. Our findings support the theory of a competitive relationship between locomotor and respiratory muscles during intense exercise. Manipulation of the work of breathing (WOB) during near-maximal exercise influences leg blood flow, but the effects on respiratory muscle blood flow are equivocal. We sought to assess leg and respiratory muscle blood flow simultaneously during intense exercise while manipulating WOB. Our hypotheses were as follows: (i) increasing the WOB would increase respiratory muscle blood flow and decrease leg blood flow; and (ii) decreasing the WOB would decrease respiratory muscle blood flow and increase leg blood flow. Eight healthy subjects (n = 5 men, n = 3 women) performed a maximal cycle test (day 1) and a series of constant-load exercise trials at 90% of peak work rate (day 2). On day 2, WOB was assessed with oesophageal balloon catheters and was increased (via resistors), decreased (via proportional assist ventilation) or unchanged (control) during the trials. Blood flow was assessed using near-infrared spectroscopy optodes placed over quadriceps and the sternocleidomastoid muscles, coupled with a venous Indocyanine Green dye injection. Changes in WOB were significantly and positively related to changes in respiratory muscle blood flow (r = 0.73), whereby increasing the WOB increased blood flow. Conversely, changes in WOB were significantly and inversely related to changes in locomotor blood flow (r = 0.57), whereby decreasing the

Recurrent Respiratory Papillomatosis or Laryngeal Papillomatosis

Science.gov (United States)

... Home » Health Info » Voice, Speech, and Language Recurrent Respiratory Papillomatosis or Laryngeal Papillomatosis On this page: What ... find additional information about RRP? What is recurrent respiratory papillomatosis? Recurrent respiratory papillomatosis (RRP) is a disease ...

Population calcium imaging of spontaneous respiratory and novel motor activity in the facial nucleus and ventral brainstem in newborn mice

DEFF Research Database (Denmark)

Persson, Karin; Rekling, Jens C

2011-01-01

The brainstem contains rhythm and pattern forming circuits, which drive cranial and spinal motor pools to produce respiratory and other motor patterns. Here we used calcium imaging combined with nerve recordings in newborn mice to reveal spontaneous population activity in the ventral brainstem...... and in the facial nucleus. In Fluo-8AM loaded brainstem-spinal cord preparations, respiratory activity on cervical nerves was synchronized with calcium signals at the ventrolateral brainstem surface. Individual ventrolateral neurons at the level of the parafacial respiratory group showed perfect or partial...... synchrony with respiratory nerve bursts. In brainstem-spinal cord preparations, cut at the level of the mid-facial nucleus, calcium signals were recorded in the dorsal, lateral and medial facial subnuclei during respiratory activity. Strong activity initiated in the dorsal subnucleus, followed by activity...

Improvement of respiratory symptoms following Heller myotomy for achalasia.

Science.gov (United States)

Khandelwal, Saurabh; Petersen, Rebecca; Tatum, Roger; Sinan, Huseyin; Aaronson, Daniel; Mier, Fernando; Martin, Ana V; Pellegrini, Carlos A; Oelschlager, Brant K

2011-02-01

Although patients with achalasia complain mainly of dysphagia, we have observed that they also have a high rate of respiratory problems. We hypothesized that the latter may be due to poor esophageal clearance leading to aspiration. This study examines the effect of Heller myotomy on these symptoms. We studied the course of 111 patients with achalasia who underwent Heller myotomy between 1994 and 2008 and who agreed to participate in this study. All patients completed a questionnaire postoperatively assessing the preoperative and postoperative prevalence and severity of symptoms using visual analog scales. Patients were divided into two groups: one that included all those with respiratory symptoms (dyspnea, hoarseness, cough, wheezing, sore throat, and/or a history of asthma or pneumonia) prior to myotomy and one that included those without those symptoms. All patients presented with dysphagia as their primary complaint, and 63 (57%) reported respiratory symptoms or disease prior to surgery. There were no significant differences in preoperative characteristics between those with and without respiratory manifestations. After a median follow-up of 71 months (range 9-186 months), 55 (87%) patients reported durable improvement of dysphagia. The frequency and severity of all respiratory symptoms decreased significantly. Twenty-four of the 29 patients (82%) who reported a history of pneumonia prior to surgery did not experience recurrent episodes after Heller myotomy. A Heller myotomy is effective in improving esophageal emptying in patients with achalasia. This results in sustained improvement of dysphagia and associated respiratory symptoms/diseases. This suggests that respiratory symptoms/diseases in these patients are likely caused by esophageal retention of food and secretions, and then aspiration.

Design of fiber optic based respiratory sensor for newborn incubator application

Science.gov (United States)

Dhia, Arika; Devara, Kresna; Abuzairi, Tomy; Poespawati, N. R.; Purnamaningsih, Retno W.

2018-02-01

This paper reports the design of respiratory sensor using fiber optic for newborn incubator application. The sensor works based on light intensity losses difference obtained due to thorax movement during respiration. The output of the sensor launched to support electronic circuits to be processed in Arduino Uno microcontroler such that the real-time respiratory rate (breath per minute) can be presented on LCD. Experiment results using thorax expansion of newborn simulator show that the system is able to measure respiratory rate from 10 up to 130 breaths per minute with 0.595% error and 0.2% hysteresis error.

Iterative integral parameter identification of a respiratory mechanics model.

Science.gov (United States)

Schranz, Christoph; Docherty, Paul D; Chiew, Yeong Shiong; Möller, Knut; Chase, J Geoffrey

2012-07-18

Patient-specific respiratory mechanics models can support the evaluation of optimal lung protective ventilator settings during ventilation therapy. Clinical application requires that the individual's model parameter values must be identified with information available at the bedside. Multiple linear regression or gradient-based parameter identification methods are highly sensitive to noise and initial parameter estimates. Thus, they are difficult to apply at the bedside to support therapeutic decisions. An iterative integral parameter identification method is applied to a second order respiratory mechanics model. The method is compared to the commonly used regression methods and error-mapping approaches using simulated and clinical data. The clinical potential of the method was evaluated on data from 13 Acute Respiratory Distress Syndrome (ARDS) patients. The iterative integral method converged to error minima 350 times faster than the Simplex Search Method using simulation data sets and 50 times faster using clinical data sets. Established regression methods reported erroneous results due to sensitivity to noise. In contrast, the iterative integral method was effective independent of initial parameter estimations, and converged successfully in each case tested. These investigations reveal that the iterative integral method is beneficial with respect to computing time, operator independence and robustness, and thus applicable at the bedside for this clinical application.

Induction of respiratory deficiency in yeast by manganese, copper, cobalt and nickel

Energy Technology Data Exchange (ETDEWEB)

Lindegren, C C; Nagai, S; Nagai, H

1958-08-16

Among the chemical agents which induce respiratory deficiency in yeasts, acriflavine, triphenyl tetrazolium chloride, p-nitrophenol, and propamidine isethionate are especially effective in producing the deficiency in a large fraction of the surviving population. The present work is a survey of the efficacy of various metallic salts in inducing respiratory deficiency.

The effect of preexisting respiratory co-morbidities on burn outcomes☆

Science.gov (United States)

Knowlin, Laquanda T.; Stanford, Lindsay B.; Cairns, Bruce A.; Charles, Anthony G.

2018-01-01

Introduction Burns cause physiologic changes in multiple organ systems in the body. Burn mortality is usually attributable to pulmonary complications, which can occur in up to 41% of patients admitted to the hospital after burn. Patients with preexisting comorbidities such as chronic lung diseases may be more susceptible. We therefore sought to examine the impact of preexisting respiratory disease on burn outcomes. Methods A retrospective analysis of patients admitted to a regional burn center from 2002–2012. Independent variables analyzed included basic demographics, burn mechanism, presence of inhalation injury, TBSA, pre-existing comorbidities, smoker status, length of hospital stay, and days of mechanical ventilation. Bivariate analysis was performed and Cox regression modeling using significant variables was utilized to estimate hazard of progression to mechanical ventilation and mortality. Results There were a total of 7640 patients over the study period. Overall survival rate was 96%. 8% (n=672) had a preexisting respiratory disease. Chronic lung disease patients had a higher mortality rate (7%) compared to those without lung disease (4%, pburn. Given the increasing number of Americans with chronic respiratory diseases, there will likely be a greater number of individuals at risk for worse outcomes following burn. PMID:28341260

Acute respiratory failure as primary manifestation of antineutrophil cytoplasmic antibodies-associated vasculitis

Directory of Open Access Journals (Sweden)

Evdokia Sourla

2014-07-01

Full Text Available The systemic vasculitides are multifocal diseases characterized by the presence of blood vessel inflammation in multiple organ systems. Their clinical presentation is variable extending from self-limited illness to critical complications including diffuse alveolar hemorrhage and glomerulonephritis. Alveolar hemorrhage is a lifethreatening manifestation of pulmonary vasculitis that can rapidly progress into acute respiratory failure requiring ventilatory support. We present the case of a 74-year-old patient admitted to the Intensive Care Unit with severe hypoxic respiratory failure and diffuse alveolar infiltrates in chest imaging that was later diagnosed as antineutrophil cytoplasmic antibodies-associated vasculitis. The report highlights the importance of differentiate between alveolar hemorrhage and acute respiratory distress syndrome of other etiology because alveolar hemorrhage is reversible with prompt initiation of treatment.

A Quick Reference on Respiratory Acidosis.

Science.gov (United States)

Johnson, Rebecca A

2017-03-01

Respiratory acidosis, or primary hypercapnia, occurs when carbon dioxide production exceeds elimination via the lung and is mainly owing to alveolar hypoventilation. Concurrent increases in Paco 2 , decreases in pH and compensatory increases in blood HCO 3 - concentration are associated with respiratory acidosis. Respiratory acidosis can be acute or chronic, with initial metabolic compensation to increase HCO 3 - concentrations by intracellular buffering. Chronic respiratory acidosis results in longer lasting increases in renal reabsorption of HCO 3 - . Alveolar hypoventilation and resulting respiratory acidosis may also be associated with hypoxemia, especially evident when patients are inspiring room air (20.9% O 2 ). Copyright © 2016 Elsevier Inc. All rights reserved.

Trends in Canadian Respiratory Clinical Trials from 2001 to 2011

Directory of Open Access Journals (Sweden)

Claire Elizabeth Tacon

2014-01-01

Full Text Available Clinical research bridges patients’ unmet medical need with innovative medicines, increases knowledge acquisition by clinicians, and creates solutions to improve the sustainability and quality of the Canadian health care system and economy. The Canadian Institutes of Health Research and the Canadian Lung Association have recently raised concerns over declining research activities within the Canadian respiratory community. While there are currently >3000 ongoing clinical trials in Canada, the number of trials investigating common respiratory diseases is unknown. The objective of the present study was to monitor the trends in industry- and non-industry-sponsored respiratory clinical trials in Canada from 2001 to 2011. Trialtrove 2012 (Citeline, an Informa UK business, a database containing summarized clinical trial information regarding pharmaceutical products, was searched using common chronic respiratory disease terms: “allergic rhinitis”, “asthma”, “chronic obstructive pulmonary disease (COPD”, “cystic fibrosis”, “respiratory infections”, “pulmonary fibrosis” and “smoking cessation”. Over the past 10 years, the number of respiratory clinical trials conducted in Canada has increased (4.49 per year; P=0.004. From 2001 to 2011, the majority of trials were performed in asthma, followed closely by respiratory infections and COPD. Over the past decade, the number of trials investigating COPD and respiratory infections increased (P<0.05, while asthma trials showed a declining trend since 2007. Of the clinical trials performed during this 10-year period, the majority were in phase III, with a significant increase in the number of phase II trials (2.49 per year; P=0.008. However, certain trends observed are concerning and warrant further monitoring in the coming years.

History of mechanical ventilation may affect respiratory mechanics evolution in acute respiratory distress syndrome.

Science.gov (United States)

Koutsoukou, Antonia; Perraki, Helen; Orfanos, Stylianos E; Koulouris, Nikolaos G; Tromaropoulos, Andreas; Sotiropoulou, Christina; Roussos, Charis

2009-12-01

The aim of this study was to investigate the effect of mechanical ventilation (MV) before acute respiratory distress syndrome (ARDS) on subsequent evolution of respiratory mechanics and blood gases in protectively ventilated patients with ARDS. Nineteen patients with ARDS were stratified into 2 groups according to ARDS onset relative to the onset of MV: In group A (n = 11), MV was applied at the onset of ARDS; in group B (n = 8), MV had been initiated before ARDS. Respiratory mechanics and arterial blood gas were assessed in early (protectively ventilated patients with ARDS, late alteration of respiratory mechanics occurs more commonly in patients who have been ventilated before ARDS onset, suggesting that the history of MV affects the subsequent progress of ARDS even when using protective ventilation.

Assessment of the swallowing function in older individuals referred to myocardial revascularization surgery.

Science.gov (United States)

Dantas, Mara de Oliveira Rodrigues Luiz; Auler, José Otávio Costa; Andrade, Claudia Regina Furquim de

2010-01-01

Swallowing evaluation of older individuals with coronary disease referred to heart surgery. To identify the characteristics of the swallowing function in older individuals referred to myocardial revascularization surgery (MR), using an evaluating protocol composed by a water test, cervical auscultation and pulse oximetry. The Assessment Protocol for Dysphagia Risk through a Combined Swallowing test and Vital Signs monitoring was used (PADTC)--measurements of HR and SpO2 (heart rate and oxygen saturation), water swallowing test with 1, 3, 5, 10, 15 e 20 ml, measurement of respiratory rate and cervical auscultation. The electronic stethoscope was used to analyze the number of swallows, response time and swallowing sound classification. In the Research Group (RG) older individuals with heart disease who were referred to MR were included. In the Control Group (CG) healthy older individuals were included. 38 older individuals were evaluated in the RG (mean age 68 years). In the CG, 30 older individuals were evaluated (mean age 70 years). There was a significant difference for the swallowing response time in older individuals with heart disease who presented HR below 60: swallowing response was shorter for 3 ml, 10 ml, 15 ml e 20 ml. HR was lower for individuals with heart disease. No significant difference was found between the groups for the other analyzed parameters. Older individuals with heart disease presented differences in the swallowing function when compared to healthy older individuals. Older individuals with heart disease presented alterations in the temporal coordination between breathing and swallowing, thus indicating risk for dysphagia.

Respiratory diseases and their effects on respiratory function and exercise capacity.

Science.gov (United States)

Van Erck-Westergren, E; Franklin, S H; Bayly, W M

2013-05-01

Given that aerobic metabolism is the predominant energy pathway for most sports, the respiratory system can be a rate-limiting factor in the exercise capacity of fit and healthy horses. Consequently, respiratory diseases, even in mild forms, are potentially deleterious to any athletic performance. The functional impairment associated with a respiratory condition depends on the degree of severity of the disease and the equestrian discipline involved. Respiratory abnormalities generally result in an increase in respiratory impedance and work of breathing and a reduced level of ventilation that can be detected objectively by deterioration in breathing mechanics and arterial blood gas tensions and/or lactataemia. The overall prevalence of airway diseases is comparatively high in equine athletes and may affect the upper airways, lower airways or both. Diseases of the airways have been associated with a wide variety of anatomical and/or inflammatory conditions. In some instances, the diagnosis is challenging because conditions can be subclinical in horses at rest and become clinically relevant only during exercise. In such cases, an exercise test may be warranted in the evaluation of the patient. The design of the exercise test is critical to inducing the clinical signs of the problem and establishing an accurate diagnosis. Additional diagnostic techniques, such as airway sampling, can be valuable in the diagnosis of subclinical lower airway problems that have the capacity to impair performance. As all these techniques become more widely used in practice, they should inevitably enhance veterinarians' diagnostic capabilities and improve their assessment of treatment effectiveness and the long-term management of equine athletes. © 2013 EVJ Ltd.

Respiratory manifestations in endocrine diseases

OpenAIRE

LENCU, CODRU?A; ALEXESCU, TEODORA; PETRULEA, MIRELA; LENCU, MONICA

2016-01-01

The control mechanisms of respiration as a vital function are complex: voluntary ? cortical, and involuntary ? metabolic, neural, emotional and endocrine. Hormones and hypothalamic neuropeptides (that act as neurotrasmitters and neuromodulators in the central nervous system) play a role in the regulation of respiration and in bronchopulmonary morphology. This article presents respiratory manifestations in adult endocrine diseases that evolve with hormone deficit or hypersecretion. In hyperthy...

High-Flow Nasal Cannula versus Conventional Oxygen Therapy in Children with Respiratory Distress.

Science.gov (United States)

Sitthikarnkha, Punthila; Samransamruajkit, Rujipat; Prapphal, Nuanchan; Deerojanawong, Jitladda; Sritippayawan, Suchada

2018-05-01

The aim of this study is to determine the clinical efficacy of high-flow nasal cannula (HFNC) therapy compared with conventional oxygen therapy in children presented with respiratory distress. This was a randomized controlled study. Infants and children aged between 1 month to 5 years who were admitted to our tertiary referral center for respiratory distress (July 1, 2014 to March 31, 2015) and met the inclusion criteria were recruited. Infants and children hospitalized with respiratory distress were randomized into two groups of interventions. All clinical data, for example, respiratory score, pulse rate, and respiratory rate were recorded. The results were subsequently analyzed. A total of 98 respiratory distress children were enrolled during the study period. Only 4 children (8.2%) failed in HFNC therapy, compared with 10 children (20.4%) in conventional oxygen therapy group ( P = 0.09). After adjusted for body weight, underlying diseases, and respiratory distress score, there was an 85% reduction in the odds of treatment failure in HFNC therapy group (adjusted odds ratio 0.15, 95% confidence interval 0.03-0.66, P = 0.01). Most children in HFNC therapy group had significant improvement in clinical respiratory score, heart rate, and respiratory rate at 240, 360, and 120 min compared with conventional oxygen therapy ( P = 0.03, 0.04, and 0.03). HFNC therapy revealed a potential clinical advantage in management children hospitalized with respiratory distress compared with conventional respiratory therapy. The early use of HFNC in children with moderate-to-severe respiratory distress may prevent endotracheal tube intubation. TCTR 20170222007.

Respiratory syncytial virus infection facilitates acute colonization of Pseudomonas aeruginosa in mice

DEFF Research Database (Denmark)

de Vrankrijker, Angélica M M; Wolfs, Tom F W; Ciofu, Oana

2009-01-01

virus infections in facilitating colonization and infection with P. aeruginosa. A study was undertaken to determine whether respiratory syncytial virus (RSV) infection could facilitate the initiation of an acute infection with P. aeruginosa in vivo. Balb/c mice were infected intranasally with P......Pseudomonas aeruginosa causes opportunistic infections in immunocompromised individuals and patients ventilated mechanically and is the major pathogen in patients with cystic fibrosis, in which it causes chronic infections. Epidemiological, in vitro and animal data suggest a role for respiratory....... These results suggest that RSV can facilitate the initiation of acute P. aeruginosa infection without the RSV infection being clinically apparent. This could have implications for treatment strategies to prevent opportunistic P. aeruginosa lung infection....

Correlation between the respiratory waveform measured using a respiratory sensor and 3D tumor motion in gated radiotherapy

International Nuclear Information System (INIS)

Tsunashima, Yoshikazu; Sakae, Takeji; Shioyama, Yoshiyuki; Kagei, Kenji; Terunuma, Toshiyuki; Nohtomi, Akihiro; Akine, Yasuyuki

2004-01-01

Purpose: The purpose of this study is to investigate the correlation between the respiratory waveform measured using a respiratory sensor and three-dimensional (3D) tumor motion. Methods and materials: A laser displacement sensor (LDS: KEYENCE LB-300) that measures distance using infrared light was used as the respiratory sensor. This was placed such that the focus was in an area around the patient's navel. When the distance from the LDS to the body surface changes as the patient breathes, the displacement is detected as a respiratory waveform. To obtain the 3D tumor motion, a biplane digital radiography unit was used. For the tumor in the lung, liver, and esophagus of 26 patients, the waveform was compared with the 3D tumor motion. The relationship between the respiratory waveform and the 3D tumor motion was analyzed by means of the Fourier transform and a cross-correlation function. Results: The respiratory waveform cycle agreed with that of the cranial-caudal and dorsal-ventral tumor motion. A phase shift observed between the respiratory waveform and the 3D tumor motion was principally in the range 0.0 to 0.3 s, regardless of the organ being measured, which means that the respiratory waveform does not always express the 3D tumor motion with fidelity. For this reason, the standard deviation of the tumor position in the expiration phase, as indicated by the respiratory waveform, was derived, which should be helpful in suggesting the internal margin required in the case of respiratory gated radiotherapy. Conclusion: Although obtained from only a few breathing cycles for each patient, the correlation between the respiratory waveform and the 3D tumor motion was evident in this study. If this relationship is analyzed carefully and an internal margin is applied, the accuracy and convenience of respiratory gated radiotherapy could be improved by use of the respiratory sensor.Thus, it is expected that this procedure will come into wider use

Respiratory health effects of air pollution: update on biomass smoke and traffic pollution.

Science.gov (United States)

Laumbach, Robert J; Kipen, Howard M

2012-01-01

Mounting evidence suggests that air pollution contributes to the large global burden of respiratory and allergic diseases, including asthma, chronic obstructive pulmonary disease, pneumonia, and possibly tuberculosis. Although associations between air pollution and respiratory disease are complex, recent epidemiologic studies have led to an increased recognition of the emerging importance of traffic-related air pollution in both developed and less-developed countries, as well as the continued importance of emissions from domestic fires burning biomass fuels, primarily in the less-developed world. Emissions from these sources lead to personal exposures to complex mixtures of air pollutants that change rapidly in space and time because of varying emission rates, distances from source, ventilation rates, and other factors. Although the high degree of variability in personal exposure to pollutants from these sources remains a challenge, newer methods for measuring and modeling these exposures are beginning to unravel complex associations with asthma and other respiratory tract diseases. These studies indicate that air pollution from these sources is a major preventable cause of increased incidence and exacerbation of respiratory disease. Physicians can help to reduce the risk of adverse respiratory effects of exposure to biomass and traffic air pollutants by promoting awareness and supporting individual and community-level interventions. Copyright © 2012 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.

Seasonality of long term wheezing following respiratory syncytial virus lower respiratory tract infection

NARCIS (Netherlands)

Bont, L.; Steijn, M.; van Aalderen, W. M. C.; Brus, F.; Th Draaisma, J. M.; van Diemen-Steenvoorde, R. A. A. M.; Pekelharing-Berghuis, M.; Kimpen, J. L. L.

2004-01-01

Background: It is well known that respiratory syncytial virus (RSV) lower respiratory tract infection (LRTI) is associated with subsequent wheezing episodes, but the precise natural course of wheezing following RSV LRTI is not known. This study aimed to determine the continuous development of

Seasonality of long term wheezing following respiratory syncytial virus lower respiratory tract infection

NARCIS (Netherlands)

Bont, L; Steijn, M; van Aalderen, WMC; Brus, F; Draaisma, JMT; Van Diemen-Steenvoorde, RAAM; Pekelharing-Berghuis, M; Kimpen, JLL

Background: It is well known that respiratory syncytial virus (RSV) lower respiratory tract infection (LRTI) is associated with subsequent wheezing episodes, but the precise natural course of wheezing following RSV LRTI is not known. This study aimed to determine the continuous development of

The global burden of respiratory infections in indigenous children and adults: A review.

Science.gov (United States)

Basnayake, Thilini L; Morgan, Lucy C; Chang, Anne B

2017-11-01

This review article focuses on common lower respiratory infections (LRIs) in indigenous populations in both developed and developing countries, where data is available. Indigenous populations across the world share some commonalities including poorer health and socio-economic disadvantage compared with their non-indigenous counterparts. Generally, acute and chronic respiratory infections are more frequent and more severe in both indigenous children and adults, often resulting in substantial consequences including higher rates of bronchiectasis and poorer outcomes for patients with chronic obstructive pulmonary disease (COPD). Risk factors for the development of respiratory infections require recognition and action. These risk factors include but are not limited to socio-economic factors (e.g. education, household crowding and nutrition), environmental factors (e.g. smoke exposure and poor access to health care) and biological factors. Risk mitigation strategies should be delivered in a culturally appropriate manner and targeted to educate both individuals and communities at risk. Improving the morbidity and mortality of respiratory infections in indigenous people requires provision of best practice care and awareness of the scope of the problem by healthcare practitioners, governing bodies and policy makers. © 2017 Asian Pacific Society of Respirology.

Neuromuscular disease and respiratory physiology in children: putting lung function into perspective.

Science.gov (United States)

Fauroux, Brigitte; Khirani, Sonia

2014-08-01

Neuromuscular diseases represent a heterogeneous group of disorders of the muscle, nerve or neuromuscular junction. The respiratory muscles are rarely spared in neuromuscular diseases even if the type of muscle involvement, severity and time course greatly varies among the different diseases. Diagnosis of respiratory muscle weakness is crucial because of the importance of respiratory morbidity and mortality. Presently, routine respiratory evaluation is based on non-invasive volitional tests, such as the measurement of lung volumes, spirometry and the maximal static pressures, which may be difficult or impossible to obtain in some young children. Other tools or parameters are thus needed to assess the respiratory muscle weakness and its consequences in young children. The measurement of oesogastric pressures can be helpful as they allow the diagnosis and quantification of paradoxical breathing, as well as the assessment of the strength of the inspiratory and expiratory muscles by means of the oesophageal pressure during a maximal sniff and of the gastric pressure during a maximal cough. Sleep assessment should also be part of the respiratory evaluation of children with neuromuscular disease with at least the recording of nocturnal gas exchange if polysomnography is not possible or unavailable. This improvement in the assessment of respiratory muscle performance may increase our understanding of the respiratory pathophysiology of the different neuromuscular diseases, improve patient care, and guide research and innovative therapies by identifying and validating respiratory parameters. © 2014 Asian Pacific Society of Respirology.

The ICRP task group respiratory tract model - an age-dependent dosimetric model for general application

International Nuclear Information System (INIS)

Bailey, M.R.; Birchall, A.

1992-01-01

The ICRP Task Group on Human Respiratory Tract Models for Radiological Protection has developed a revised dosimetric model for the respiratory tract. Papers outlining the model, and describing each aspect of it were presented at the Third International Workshop on Respiratory Tract Dosimetry (Albuquerque 1-3 July 1990), the Proceedings of which were recently published in Radiation Protection Dosimetry Volume 38 Nos 1-3 (1991). Since the model had not changed substantially since the Workshop at Albuquerque, only a summary of the paper presented at Schloss Elmau is included in these Proceedings. (author)

Genetic Testing for Respiratory Disease: Are We There Yet?

Directory of Open Access Journals (Sweden)

Peter D Paré

2012-01-01

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

Vena Cava Responsiveness to Controlled Isovolumetric Respiratory Efforts.

Science.gov (United States)

Folino, Anna; Benzo, Marco; Pasquero, Paolo; Laguzzi, Andrea; Mesin, Luca; Messere, Alessandro; Porta, Massimo; Roatta, Silvestro

2017-10-01

Respirophasic variation of inferior vena cava (IVC) size is affected by large variability with spontaneous breathing. This study aims at characterizing the dependence of IVC size on controlled changes in intrathoracic pressure. Ten healthy subjects, in supine position, performed controlled isovolumetric respiratory efforts at functional residual capacity, attaining positive (5, 10, and 15 mmHg) and negative (-5, -10, and -15 mmHg) alveolar pressure levels. The isovolumetric constraint implies that equivalent changes are exhibited by alveolar and intrathoracic pressures during respiratory tasks. The IVC cross-sectional area equal to 2.88 ± 0.43 cm 2 at baseline (alveolar pressure = 0 mmHg) was progressively decreased by both expiratory and inspiratory efforts of increasing strength, with diaphragmatic efforts producing larger effects than thoracic ones: -55 ± 15% decrease, at +15 mmHg of alveolar pressure (P < .01), -80 ± 33 ± 12% at -15 mmHg diaphragmatic (P < .01), -33 ± 12% at -15 mmHg thoracic. Significant IVC changes in size (P < .01) and pulsatility (P < .05), along with non significant reduction in the response to respiratory efforts, were also observed during the first 30 minutes of supine rest, detecting an increase in vascular filling, and taking place after switching from the standing to the supine position. This study quantified the dependence of the IVC cross-sectional area on controlled intrathoracic pressure changes and evidenced the stronger influence of diaphragmatic over thoracic activity. Individual variability in thoracic/diaphragmatic respiratory pattern should be considered in the interpretation of the respirophasic modulations of IVC size. © 2017 by the American Institute of Ultrasound in Medicine.

Respiratory hospitalizations of children and residential exposure to traffic air pollution in Jerusalem.

Science.gov (United States)

Nirel, Ronit; Schiff, Michal; Paltiel, Ora

2015-01-01

Although exposure to traffic-related air pollution has been reported to be associated with respiratory morbidity in children, this association has not been examined in Israel. Jerusalem is ranked among the leading Israeli cities in transport-related air pollution. This case-control study examined whether pediatric hospitalization for respiratory diseases in Jerusalem is related to residential exposure to traffic-related air pollution. Cases (n=4844) were Jerusalem residents aged 0-14 years hospitalized for respiratory illnesses between 2000 and 2006. These were compared to children admitted electively (n=2161) or urgently (n=3085) for non-respiratory conditions. Individual measures of exposure included distance from residence to nearest main road, the total length of main roads, traffic volume, and bus load within buffers of 50, 150, and 300m around each address. Cases were more likely to have any diesel buses passing within 50m of their home (adjusted odds ratios=1.16 and 1.10, 95% confidence intervals 1.04-1.30 and 1.01-1.20 for elective and emergency controls, respectively). Our findings indicated that older girls (5-14) and younger boys (0-4) had increased risks of respiratory hospitalization, albeit with generally widened confidence intervals due to small sample sizes. Our results add to the limited body of evidence regarding associations between diesel exhaust particles and respiratory morbidity. The findings also point to possible differential associations between traffic-related air pollution and pediatric hospitalization among boys and girls in different age groups. Copyright © 2014 Elsevier GmbH. All rights reserved.

A Comparative Study of Clinical Presentation and Risk Factors for Adverse Outcome in Patients Hospitalised with Acute Respiratory Disease Due to MERS Coronavirus or Other Causes.

Directory of Open Access Journals (Sweden)

Musa A Garbati

Full Text Available Middle East Respiratory syndrome (MERS first emerged in Saudi Arabia in 2012 and remains a global health concern. The objective of this study was to compare the clinical features and risk factors for adverse outcome in patients with RT-PCR confirmed MERS and in those with acute respiratory disease who were MERS-CoV negative, presenting to the King Fahad Medical City (KFMC in Riyadh between October 2012 and May 2014. The demographics, clinical and laboratory characteristics and clinical outcomes of patients with RT-PCR confirmed MERS-CoV infection was compared with those testing negative MERS-CoV PCR. Health care workers (HCW with MERS were compared with MERS patients who were not health care workers. One hundred and fifty nine patients were eligible for inclusion. Forty eight tested positive for MERS CoV, 44 (92% being hospital acquired infections and 23 were HCW. There were 111 MERS-CoV negative patients with acute respiratory illnesses included in this study as "negative controls". Patient with confirmed MERS-CoV infection were not clinically distinguishable from those with negative MERS-CoV RT-PCR results although diarrhoea was commoner in MERS patients. A high level of suspicion in initiating laboratory tests for MERS-CoV is therefore indicated. Variables associated with adverse outcome were older age and diabetes as a co-morbid illness. Interestingly, co-morbid illnesses other than diabetes were not significantly associated with poor outcome. Health care workers with MERS had a markedly better clinical outcome compared to non HCW MERS patients.

29 CFR 1915.154 - Respiratory protection.

Science.gov (United States)

2010-07-01

... 29 Labor 7 2010-07-01 2010-07-01 false Respiratory protection. 1915.154 Section 1915.154 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR... (PPE) § 1915.154 Respiratory protection. Respiratory protection for shipyard employment is covered by...

33 CFR 127.1209 - Respiratory protection.

Science.gov (United States)

2010-07-01

... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Respiratory protection. 127.1209... Waterfront Facilities Handling Liquefied Hazardous Gas Equipment § 127.1209 Respiratory protection. Each waterfront facility handling LHG must provide equipment for respiratory protection for each employee of the...

Association between indoor air pollution and respiratory disease in companion dogs and cats.

Science.gov (United States)

Lin, Chung-Hui; Lo, Pei-Ying; Wu, Huey-Dong; Chang, Chinhao; Wang, Lih-Chiann

2018-05-01

Indoor air pollution (IAP) leads to important respiratory morbidity and mortality in humans. Companion dogs and cats share the same household environment with their owners and are exposed to IAP. Pets with respiratory disease are more commonly exposed to indoor air pollutants in their homes and to worse air quality than pets without respiratory disease. Three hundred and forty-eight animals (230 dogs and 118 cats) were recruited. Dogs and cats attending the National Taiwan University Veterinary Hospital were prospectively enrolled over a 12-month period. Questionnaires were collected from pet owners regarding the status of signs of respiratory problem of animals and air pollutants in their homes. Clinical assessment was performed by veterinarians on all animals included in the case-control study and the presence/absence of respiratory disease and diagnoses were recorded. Individual exposure to particulate matter of 2.5 μm or less (PM2.5) was estimated in the domestic microenvironment of the animals. Dogs with respiratory disease were more commonly exposed to incense burning than control dogs (30 versus 13%, P = .045), but household PM2.5 level was not different between dogs with and without respiratory disease [median 30.8 μg/m 3 , range 10.8-214.2 versus median 38.2 μg/m 3 , range 5.4-69.4, P = .57]. Signalment factors (age, body weight, and body condition score) instead of IAP factors were associated with respiratory disease in dogs using multivariable logistic regression. In contrast, household PM2.5 level was significantly higher in cats with respiratory disease than in control cats [median 38.6 μg/m 3 , range 17.8-131.2 versus median 27.4 μg/m 3 , range 15.4-70.0, P = .017]. Cats living in households with PM2.5 > 35 μg/m 3 were more likely to have respiratory disease than those living in households with acceptable levels of PM2.5 (OR = 4.13, 95% CI 1.12-15.27, P = .03). The link between IAP and respiratory disease in dogs is

Respiratory alkalosis in children with febrile seizures.

Science.gov (United States)

Schuchmann, Sebastian; Hauck, Sarah; Henning, Stephan; Grüters-Kieslich, Annette; Vanhatalo, Sampsa; Schmitz, Dietmar; Kaila, Kai

2011-11-01

Febrile seizures (FS) are the most common type of convulsive events in children. FS are suggested to result from a combination of genetic and environmental factors. However, the pathophysiologic mechanisms underlying FS remain unclear. Using an animal model of experimental FS, it was demonstrated that hyperthermia causes respiratory alkalosis with consequent brain alkalosis and seizures. Here we examine the acid-base status of children who were admitted to the hospital for FS. Children who were admitted because of gastroenteritis (GE), a condition known to promote acidosis, were examined to investigate a possible protective effect of acidosis against FS. We enrolled 433 age-matched children with similar levels of fever from two groups presented to the emergency department. One group was admitted for FS (n = 213) and the other for GE (n = 220). In the FS group, the etiology of fever was respiratory tract infection (74.2%), otitis media (7%), GE (7%), tonsillitis (4.2%), scarlet fever (2.3%) chickenpox (1.4%), urinary tract infection (1.4%), postvaccination reaction (0.9%), or unidentified (1.4%). In all patients, capillary pH and blood Pco(2) were measured immediately on admission to the hospital. Respiratory alkalosis was found in children with FS (pH 7.46 ± 0.04, [mean ± standard deviation] Pco(2) 29.5 ± 5.5 mmHg), whereas a metabolic acidosis was seen in all children admitted for GE (pH 7.31 ± 0.03, Pco(2) 37.7 ± 4.3 mmHg; p respiratory alkalosis, irrespective of the severity of the underlying infection as indicated by the level of fever. The lack of FS in GE patients is attributable to low pH, which also explains the fact that children with a susceptibility to FS do not have seizures when they have GE-induced fever that is associated with acidosis. The present demonstration of a close link between FS and respiratory alkalosis may pave the way for further clinical studies and attempts to design novel therapies for the treatment of FS by controlling the

McArdle's Disease Presenting as Unexplained Dyspnea in a Young Woman

Directory of Open Access Journals (Sweden)

Nha Voduc

2004-01-01

Full Text Available McArdle's disease is a rare, inherited deficiency of myophosphorylase, an enzyme required for the utilization of glycogen. Patients with myophosphorylase deficiency classically present with exercise intolerance, leg pain and muscle fatigue. The case of a young woman with exertional dyspnea and leg cramps is described. Exercise testing confirmed the presence of exercise intolerance and demonstrated an accelerated heart rate response, despite the absence of an anaerobic threshold and a respiratory exchange ratio of less than 1.0. Subsequent ischemic forearm testing and muscle biopsy confirmed the diagnosis of myophosphorylase deficiency. Evaluation of lung mechanics with esophageal pressure measurements demonstrated the presence of respiratory muscle weakness and early fatiguability, suggesting that the patient's dyspnea might have been attributable to an increased respiratory effort. Dyspnea is not a classic symptom associated with myophosphorylase deficiency, although subclinical respiratory muscle impairment may be present. No previous studies have evaluated respiratory muscle function during exercise in patients with myophosphorylase deficiency.

Respiratory infections in adults with atopic disease and IgE antibodies to common aeroallergens.

Directory of Open Access Journals (Sweden)

Aino Rantala

Full Text Available BACKGROUND: Atopic diseases, including allergic rhinitis, allergic dermatitis and asthma, are common diseases with a prevalence of 30-40% worldwide and are thus of great global public health importance. Allergic inflammation may influence the immunity against infections, so atopic individuals could be susceptible to respiratory infections. No previous population-based study has addressed the relation between atopy and respiratory infections in adulthood. We assessed the relation between atopic disease, specific IgE antibodies and the occurrence of upper and lower respiratory infections in the past 12 months among working-aged adults. METHODS AND FINDINGS: A population-based cross-sectional study of 1008 atopic and non-atopic adults 21-63 years old was conducted. Information on atopic diseases, allergy tests and respiratory infections was collected by a questionnaire. Specific IgE antibodies to common aeroallergens were measured in serum. Adults with atopic disease had a significantly increased risk of lower respiratory tract infections (LRTI; including acute bronchitis and pneumonia with an adjusted risk ratio (RR 2.24 (95% confidence interval [CI] 1.43, 3.52 and upper respiratory tract infections (URTI; including common cold, sinusitis, tonsillitis, and otitis media with an adjusted RR 1.55 (1.14, 2.10. The risk of LRTIs increased with increasing level of specific IgE (linear trend P = 0.059. CONCLUSIONS: This study provides new evidence that working-aged adults with atopic disease experience significantly more LRTIs and URTIs than non-atopics. The occurrence of respiratory infections increased with increasing levels of specific IgE antibodies to common aeroallergens, showing a dose-response pattern with LRTIs. From the clinical point of view it is important to recognize that those with atopies are a risk group for respiratory infections, including more severe LRTIs.

Antitussive pharmaceutical drugs administration in complex therapy of acute respiratory infections in children

OpenAIRE

Lokshina, E.; Zajtseva, O.

2009-01-01

There is considered the problem of treatment of cough in children with acute respiratory infections in article. In particular, the data on an effective administration of the domestic combined medication framed on basis of medicinal grasses with codeine in complex therapy of acute respiratory infections is presented.

Extraction of the respiratory signal from small-animal CT projections for a retrospective gating method

Energy Technology Data Exchange (ETDEWEB)

ChavarrIas, C; Vaquero, J J; Sisniega, A; RodrIguez-Ruano, A; Soto-Montenegro, M L; GarcIa-Barreno, P; Desco, M [Unidad de Medicina y CirugIa Experimental, Hospital General Universitario Gregorio Maranon, Anexo PsiquiatrIa, 1 Planta. C/Ibiza, 43. Madrid 28007 (Spain)

2008-09-07

We propose a retrospective respiratory gating algorithm to generate dynamic CT studies. To this end, we compared three different methods of extracting the respiratory signal from the projections of small-animal cone-beam computed tomography (CBCT) scanners. Given a set of frames acquired from a certain axial angle, subtraction of their average image from each individual frame produces a set of difference images. Pixels in these images have positive or negative values (according to the respiratory phase) in those areas where there is lung movement. The respiratory signals were extracted by analysing the shape of the histogram of these difference images: we calculated the first four central and non-central moments. However, only odd-order moments produced the desired breathing signal, as the even-order moments lacked information about the phase. Each of these curves was compared to a reference signal recorded by means of a pneumatic pillow. Given the similar correlation coefficients yielded by all of them, we selected the mean to implement our retrospective protocol. Respiratory phase bins were separated, reconstructed independently and included in a dynamic sequence, suitable for cine playback. We validated our method in five adult rat studies by comparing profiles drawn across the diaphragm dome, with and without retrospective respiratory gating. Results showed a sharper transition in the gated reconstruction, with an average slope improvement of 60.7%.

Extraction of the respiratory signal from small-animal CT projections for a retrospective gating method

International Nuclear Information System (INIS)

ChavarrIas, C; Vaquero, J J; Sisniega, A; RodrIguez-Ruano, A; Soto-Montenegro, M L; GarcIa-Barreno, P; Desco, M

2008-01-01

We propose a retrospective respiratory gating algorithm to generate dynamic CT studies. To this end, we compared three different methods of extracting the respiratory signal from the projections of small-animal cone-beam computed tomography (CBCT) scanners. Given a set of frames acquired from a certain axial angle, subtraction of their average image from each individual frame produces a set of difference images. Pixels in these images have positive or negative values (according to the respiratory phase) in those areas where there is lung movement. The respiratory signals were extracted by analysing the shape of the histogram of these difference images: we calculated the first four central and non-central moments. However, only odd-order moments produced the desired breathing signal, as the even-order moments lacked information about the phase. Each of these curves was compared to a reference signal recorded by means of a pneumatic pillow. Given the similar correlation coefficients yielded by all of them, we selected the mean to implement our retrospective protocol. Respiratory phase bins were separated, reconstructed independently and included in a dynamic sequence, suitable for cine playback. We validated our method in five adult rat studies by comparing profiles drawn across the diaphragm dome, with and without retrospective respiratory gating. Results showed a sharper transition in the gated reconstruction, with an average slope improvement of 60.7%

Multigenerational links between mothers' experiences of autonomy in childhood and preschoolers' respiratory sinus arrhythmia: Variations by maltreatment status.

Science.gov (United States)

Noll, Laura K; Clark, Caron A C; Skowron, Elizabeth A

2015-11-01

Despite burgeoning evidence linking early exposure to child maltreatment (CM) to deficits in self-regulation, the pathways to strong regulatory development in these children are not well understood, and significant heterogeneity is observed in their outcomes. Experiences of autonomy may play a key role in transmitting self-regulatory capacity across generations and help explain individual differences in maltreatment outcomes. In this study, we investigated multigenerational associations between Generation 1 (G1)-Generation 2 (G2) mothers' early experience of warmth and autonomy in relation to their own mothers and their Generation 3 (G3) children's autonomic physiological regulation in CM (n = 85) and non-CM (n = 128) families. We found that G2 mothers who recalled greater autonomy in their childhood relationship with their G1 mothers had preschool-age G3 children with higher respiratory sinus arrhythmia at baseline when alone while engaged in individual challenge tasks, during social exchanges with their mother in joint challenge tasks, and during the portions of the strange situation procedure when the mother was present. Although no clear mediators of this association emerged, multigenerational links among G1-G2 relations, maternal representations of her child, child behavior, and child respiratory sinus arrhythmia differed by maltreatment status, thus possibly representing important targets for future research and intervention.

Incidence of Changes in Respiration-Induced Tumor Motion and Its Relationship With Respiratory Surrogates During Individual Treatment Fractions

International Nuclear Information System (INIS)

Malinowski, Kathleen; McAvoy, Thomas J.; George, Rohini; Dietrich, Sonja; D’Souza, Warren D.

2012-01-01

Purpose: To determine how frequently (1) tumor motion and (2) the spatial relationship between tumor and respiratory surrogate markers change during a treatment fraction in lung and pancreas cancer patients. Methods and Materials: A Cyberknife Synchrony system radiographically localized the tumor and simultaneously tracked three respiratory surrogate markers fixed to a form-fitting vest. Data in 55 lung and 29 pancreas fractions were divided into successive 10-min blocks. Mean tumor positions and tumor position distributions were compared across 10-min blocks of data. Treatment margins were calculated from both 10 and 30 min of data. Partial least squares (PLS) regression models of tumor positions as a function of external surrogate marker positions were created from the first 10 min of data in each fraction; the incidence of significant PLS model degradation was used to assess changes in the spatial relationship between tumors and surrogate markers. Results: The absolute change in mean tumor position from first to third 10-min blocks was >5 mm in 13% and 7% of lung and pancreas cases, respectively. Superior–inferior and medial–lateral differences in mean tumor position were significantly associated with the lobe of lung. In 61% and 54% of lung and pancreas fractions, respectively, margins calculated from 30 min of data were larger than margins calculated from 10 min of data. The change in treatment margin magnitude for superior–inferior motion was >1 mm in 42% of lung and 45% of pancreas fractions. Significantly increasing tumor position prediction model error (mean ± standard deviation rates of change of 1.6 ± 2.5 mm per 10 min) over 30 min indicated tumor–surrogate relationship changes in 63% of fractions. Conclusions: Both tumor motion and the relationship between tumor and respiratory surrogate displacements change in most treatment fractions for patient in-room time of 30 min.

Incidence of Changes in Respiration-Induced Tumor Motion and Its Relationship With Respiratory Surrogates During Individual Treatment Fractions

Energy Technology Data Exchange (ETDEWEB)

Malinowski, Kathleen [Department of Bioengineering, A. James Clark School of Engineering, University of Maryland, College Park, MD (United States); Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, MD (United States); McAvoy, Thomas J. [Department of Bioengineering, A. James Clark School of Engineering, University of Maryland, College Park, MD (United States); Institute of Systems Research, University of Maryland, College Park, MD (United States); George, Rohini [Department of Bioengineering, A. James Clark School of Engineering, University of Maryland, College Park, MD (United States); Dietrich, Sonja [Department of Radiation Oncology, Stanford University School of Medicine, Palo Alto, CA (United States); D' Souza, Warren D., E-mail: wdsou001@umaryland.edu [Department of Bioengineering, A. James Clark School of Engineering, University of Maryland, College Park, MD (United States); Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, MD (United States)

2012-04-01

Purpose: To determine how frequently (1) tumor motion and (2) the spatial relationship between tumor and respiratory surrogate markers change during a treatment fraction in lung and pancreas cancer patients. Methods and Materials: A Cyberknife Synchrony system radiographically localized the tumor and simultaneously tracked three respiratory surrogate markers fixed to a form-fitting vest. Data in 55 lung and 29 pancreas fractions were divided into successive 10-min blocks. Mean tumor positions and tumor position distributions were compared across 10-min blocks of data. Treatment margins were calculated from both 10 and 30 min of data. Partial least squares (PLS) regression models of tumor positions as a function of external surrogate marker positions were created from the first 10 min of data in each fraction; the incidence of significant PLS model degradation was used to assess changes in the spatial relationship between tumors and surrogate markers. Results: The absolute change in mean tumor position from first to third 10-min blocks was >5 mm in 13% and 7% of lung and pancreas cases, respectively. Superior-inferior and medial-lateral differences in mean tumor position were significantly associated with the lobe of lung. In 61% and 54% of lung and pancreas fractions, respectively, margins calculated from 30 min of data were larger than margins calculated from 10 min of data. The change in treatment margin magnitude for superior-inferior motion was >1 mm in 42% of lung and 45% of pancreas fractions. Significantly increasing tumor position prediction model error (mean {+-} standard deviation rates of change of 1.6 {+-} 2.5 mm per 10 min) over 30 min indicated tumor-surrogate relationship changes in 63% of fractions. Conclusions: Both tumor motion and the relationship between tumor and respiratory surrogate displacements change in most treatment fractions for patient in-room time of 30 min.

Towards estimation of respiratory muscle effort with respiratory inductance plethysmography signals and complementary ensemble empirical mode decomposition.

Science.gov (United States)

Chen, Ya-Chen; Hsiao, Tzu-Chien

2018-07-01

Respiratory inductance plethysmography (RIP) sensor is an inexpensive, non-invasive, easy-to-use transducer for collecting respiratory movement data. Studies have reported that the RIP signal's amplitude and frequency can be used to discriminate respiratory diseases. However, with the conventional approach of RIP data analysis, respiratory muscle effort cannot be estimated. In this paper, the estimation of the respiratory muscle effort through RIP signal was proposed. A complementary ensemble empirical mode decomposition method was used, to extract hidden signals from the RIP signals based on the frequency bands of the activities of different respiratory muscles. To validate the proposed method, an experiment to collect subjects' RIP signal under thoracic breathing (TB) and abdominal breathing (AB) was conducted. The experimental results for both the TB and AB indicate that the proposed method can be used to loosely estimate the activities of thoracic muscles, abdominal muscles, and diaphragm. Graphical abstract ᅟ.

Coal Mining-Related Respiratory Diseases

Science.gov (United States)

... Topics Publications and Products Programs Contact NIOSH NIOSH COAL WORKERS' HEALTH SURVEILLANCE PROGRAM Recommend on Facebook Tweet Share Compartir Coal Mining-Related Respiratory Diseases Coal mining-related respiratory ...

Maternal and neonatal outcomes of respiratory failure during pregnancy.

Science.gov (United States)

Hung, Chen-Yiu; Hu, Han-Chung; Chiu, Li-Chung; Chang, Chih-Hao; Li, Li-Fu; Huang, Chung-Chi; Kao, Chuan-Chi; Cheng, Po-Jen; Kao, Kuo-Chin

2018-05-01

Obstetric patients comprise a limited portion of intensive care unit patients, but they often present with unfamiliar conditions and exhibit the potential for catastrophic deterioration. This study evaluated the maternal and neonatal outcomes of respiratory failure during pregnancy. Information on 71 patients at >25 weeks gestation in the ICU with respiratory failure was recorded between 2009 and 2013. The characteristics and outcomes of mothers and fetuses were determined through a retrospective chart review and evaluated using Student's t test, chi-square test, and Fisher's exact test. The leading causes of respiratory failure were postpartum hemorrhage and severe preeclampsia in the obstetric causes group and pneumonia in the nonobstetric causes group during pregnancy and the peripartum period. The non-obstetric causes group exhibited a higher incidence of acute respiratory distress syndrome and renal replacement therapy as well as requiring more ventilator days. The patients in the obstetric causes group showed significant improvement after delivery in the partial pressure of arterial oxygen to the fraction of inspired oxygen and peak inspiratory pressure decrease. Both groups exhibited high incidences of neonatal respiratory distress syndrome. Neonatal complications resulting from meconium aspiration syndrome (MAS) and sepsis were more common in the non-obstetric causes group; however, neurological development impairment was more common in the obstetric causes group. Obstetric cause was associated with longer ventilator free days and fewer episodes of ARDS after delivery. Neonatal complications resulting from different etiologies of respiratory failure were found to differ. Copyright © 2017. Published by Elsevier B.V.

Occupational risk factors for chronic respiratory disease in a New Zealand population using lifetime occupational history.

Science.gov (United States)

Hansell, Anna; Ghosh, Rebecca E; Poole, Suzanne; Zock, Jan-Paul; Weatherall, Mark; Vermeulen, Roel; Kromhout, Hans; Travers, Justin; Beasley, Richard

2014-03-01

To investigate associations between respiratory disease and occupational exposures in a New Zealand urban population, the Wellington Respiratory Survey. Multiple regression analyses in a population sample of 1017 individuals aged 25 to 74 years with spirometry and questionnaire information, including a lifetime occupational history. Chronic bronchitis symptoms were associated with self-reported exposure to hairdressing, paint manufacturing, insecticides, welding, detergents and with ALOHA Job Exposure Matrix-assessed gases/fumes exposure. The strongest association was for hairdressing (odds ratio 6.91; 95% confidence interval: 2.02 to 23.70). Cumulative exposure to mineral dust and gases/fumes was associated with higher FEV₁% (forced expiratory volume in the first second of expiration) predicted. Analyses were limited by relatively small numbers of cases. Increased risks of objectively defined respiratory disease, which have been previously documented, were not seen. Nevertheless, the study suggested increased risk of respiratory symptoms with various occupational exposures as well as likely healthy worker effect.

Automatic tumour volume delineation in respiratory-gated PET images

International Nuclear Information System (INIS)

Gubbi, Jayavardhana; Palaniswami, Marimuthu; Kanakatte, Aparna; Mani, Nallasamy; Kron, Tomas; Binns, David; Srinivasan, Bala

2011-01-01

Positron emission tomography (PET) is a state-of-the-art functional imaging technique used in the accurate detection of cancer. The main problem with the tumours present in the lungs is that they are non-stationary during each respiratory cycle. Tumours in the lungs can get displaced up to 2.5 cm during respiration. Accurate detection of the tumour enables avoiding the addition of extra margin around the tumour that is usually used during radiotherapy treatment planning. This paper presents a novel method to detect and track tumour in respiratory-gated PET images. The approach followed to achieve this task is to automatically delineate the tumour from the first frame using support vector machines. The resulting volume and position information from the first frame is used in tracking its motion in the subsequent frames with the help of level set (LS) deformable model. An excellent accuracy of 97% is obtained using wavelets and support vector machines. The volume calculated as a result of the machine learning (ML) stage is used as a constraint for deformable models and the tumour is tracked in the remaining seven phases of the respiratory cycle. As a result, the complete information about tumour movement during each respiratory cycle is available in relatively short time. The combination of the LS and ML approach accurately delineated the tumour volume from all frames, thereby providing a scope of using PET images towards planning an accurate and effective radiotherapy treatment for lung cancer.

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

RATIONALE: A pilot study (Bisgaard H; Study Group on Montelukast and Respiratory Syncytial Virus. A randomized trial of montelukast in respiratory syncytial virus postbronchiolitis. Am J Respir Crit Care Med 2003;167:379-383) reported the efficacy of montelukast in post-respiratory syncytial viru...

Megacomplex organization of the oxidative phosphorylation system by structural analysis of respiratory supercomplexes from potato

NARCIS (Netherlands)

Bultema, Jelle B.; Braun, Hans-Peter; Boekema, Egbert J.; Kouřil, Roman

The individual protein complexes of the oxidative phosphorylation system (OXPHOS complexes 1 to V) specifically interact and form defined supramolecular structures, the so-called "respiratory supercomplexes". Some supercomplexes appear to associate into larger structures, or megacomplexes, such as a

Respiratory medicine of reptiles.

Science.gov (United States)

Schumacher, Juergen

2011-05-01

Noninfectious and infectious causes have been implicated in the development of respiratory tract disease in reptiles. Treatment modalities in reptiles have to account for species differences in response to therapeutic agents as well as interpretation of diagnostic findings. Data on effective drugs and dosages for the treatment of respiratory diseases are often lacking in reptiles. Recently, advances have been made on the application of advanced imaging modalities, especially computed tomography for the diagnosis and treatment monitoring of reptiles. This article describes common infectious and noninfectious causes of respiratory disease in reptiles, including diagnostic and therapeutic regimen. Copyright © 2011 Elsevier Inc. All rights reserved.

Delayed cystic fibrosis presentation in children in the absence of newborn screening.

LENUS (Irish Health Repository)

Jackson, A

2010-04-01

Newborn cystic fibrosis (CF) screening facilitates early diagnosis and nutritional intervention, which prevents malnourishment and improves growth in childhood. To provide baseline information on the natural history of CF in the Republic of Ireland, where newborn screening has not yet been introduced and CF incidence is high (1:1353 live births), we examined the effect of presentation mode, symptom type and gender on age at diagnosis. Median age at diagnosis was calculated by gender and for presentation mode\\/symptom type for 601 CF registry children diagnosed 1986-2007. Modes of presentation were each significantly associated with delayed presentation. An adjusted odds ratio of 4.5 (95% CI: 1.8, 11.1) was determined for presentation with family history, 43.1 for gastrointestinal symptoms presentation (95% CI: 18.3, 101.4), 96.9 for both respiratory and gastrointestinal symptoms (95% CI: 38.6, 243,4), and 115.4 for respiratory symptoms (95% CI: 45.2, 294.7). Children with respiratory symptoms had the greatest likelihood of delayed diagnosis (median age: 20.4 months), followed by those with respiratory and gastrointestinal symptoms (9.2 months). Gender was not significantly associated with a delayed presentation when presentation mode was taken into account.

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…

Fusobacterium necrophorum presenting as isolated lung nodules

Directory of Open Access Journals (Sweden)

Rajiv Sonti

2015-01-01

Full Text Available Fusobacterium necrophorum causes Lemierre's syndrome - a dramatic and distinct condition beginning with pharyngitis before proceeding to internal jugular vein septic thrombophlebitis and respiratory tract infection in otherwise healthy individuals. It is rare, but by far the most common pathway to parenchymal lung disease with this organism. Here we describe we a 34 year old healthy lady who was nontoxic without any antecedent illness who presented with lung nodules due to fusobacterium necrophorum as the sole manifestation of disease. Leading diagnostic consideration prior to culture data was pulmonary vasculitis. Identifying her disease process was a somewhat chance occurrence, and it began to resolve prior to antibiotic therapy. Though it would be difficult to recommend keen awareness of this organism given its rarity, it is important to consider that its scope may be broader than traditionally considered.

PROGRAM RATIONALE OF TREATMENT AND PREVENTION IN CHILDREN WITH FREQUENT RESPIRATORY DISEASES

Directory of Open Access Journals (Sweden)

A. V. Deryusheva

2017-01-01

Full Text Available The results of complex clinical and laboratory examination of 146 children aged 2—3 years attending kindergarten were presented. The leading predictors of frequent respiratory disease: disturbance of microbiocenosis oropharyngeal mucosa, immunoglobulins decrease, respiratory allergic pathology were established and scientifically substantiated. The results obtained prove the main directions of therapeutic and preventive measures.

46 CFR 154.1405 - Respiratory protection.

Science.gov (United States)

2010-10-01

... 46 Shipping 5 2010-10-01 2010-10-01 false Respiratory protection. 154.1405 Section 154.1405... Equipment § 154.1405 Respiratory protection. When Table 4 references this section, a vessel carrying the listed cargo must have: (a) Respiratory protection equipment for each person on board that protects the...

Clinical presentation of metabolic alkalosis in an adult patient with cystic fibrosis.

Science.gov (United States)

Sweetser, Lisel J; Douglas, James A; Riha, Renata L; Bell, Scott C

2005-03-01

In subtropical and tropical climates, dehydration is common in cystic fibrosis patients with respiratory exacerbations. This may lead to a clinical presentation of metabolic alkalosis with associated hyponatraemia and hypochloraemia. An adult cystic fibrosis patient who presented with a severe respiratory exacerbation accompanied by metabolic alkalosis is presented and the effects of volume correction are reported.

Malignant peritoneal mesothelioma presenting with respiratory symptoms

Energy Technology Data Exchange (ETDEWEB)

Daskalogiannaki, M.; Prassopoulos, P.; Raissaki, M.; Gourtsoyiannis, N. [Dept. of Radiology, University Hospital of Heraklion (Greece); Tsardi, M. [Dept. of Pathology, University Hospital of Heraklion (Greece)

2000-05-01

Malignant peritoneal mesothelioma is a rare disease associated with mild, nonspecific abdominal symptoms and a wide spectrum of imaging findings, with thickened mesentery and peritoneum being the most common ones. A case of a malignant peritoneal mesothelioma presenting with manifestations of pulmonary disease is reported. Imaging evaluation revealed pleural, lung and pericardial involvement together with retroperitoneal lymphadenopathy, little ascites and extensive omental, but only subtle, mesenteric thickening. (orig.)

Middle East Respiratory Syndrome (MERS)

Science.gov (United States)

Middle East Respiratory Syndrome Coronavirus; MERS-CoV; Novel coronavirus; nCoV ... for Disease Control and Prevention website. Middle East Respiratory Syndrome (MERS): Frequently asked questions and answers. www. ...

Perceived Competence and Comfort in Respiratory Protection

Science.gov (United States)

Burgel, Barbara J.; Novak, Debra; Burns, Candace M.; Byrd, Annette; Carpenter, Holly; Gruden, MaryAnn; Lachat, Ann; Taormina, Deborah

2015-01-01

In response to the Institute of Medicine (2011) report Occupational Health Nurses and Respiratory Protection: Improving Education and Training, a nationwide survey was conducted in May 2012 to assess occupational health nurses’ educational preparation, roles, responsibilities, and training needs in respiratory protection. More than 2,000 occupational health nurses responded; 83% perceived themselves as competent, proficient, or expert in respiratory protection, reporting moderate comfort with 12 respiratory program elements. If occupational health nurses had primary responsibility for the respiratory protection program, they were more likely to perceive higher competence and more comfort in respiratory protection, after controlling for occupational health nursing experience, highest education, occupational health nursing certification, industry sector, Association of Occupational Health Professionals in Healthcare membership, taking a National Institute for Occupational Safety and Health spirometry course in the prior 5 years, and perceiving a positive safety culture at work. These survey results document high perceived competence and comfort in respiratory protection. These findings support the development of targeted educational programs and interprofessional competencies for respiratory protection. PMID:23429638

Obesity and respiratory diseases

Directory of Open Access Journals (Sweden)

Christopher Zammit

2010-10-01

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

Respiratory flow-sound relationship during both wakefulness and sleep and its variation in relation to sleep apnea.

Science.gov (United States)

Yadollahi, Azadeh; Montazeri, Aman; Azarbarzin, Ali; Moussavi, Zahra

2013-03-01

Tracheal respiratory sound analysis is a simple and non-invasive way to study the pathophysiology of the upper airway and has recently been used for acoustic estimation of respiratory flow and sleep apnea diagnosis. However in none of the previous studies was the respiratory flow-sound relationship studied in people with obstructive sleep apnea (OSA), nor during sleep. In this study, we recorded tracheal sound, respiratory flow, and head position from eight non-OSA and 10 OSA individuals during sleep and wakefulness. We compared the flow-sound relationship and variations in model parameters from wakefulness to sleep within and between the two groups. The results show that during both wakefulness and sleep, flow-sound relationship follows a power law but with different parameters. Furthermore, the variations in model parameters may be representative of the OSA pathology. The other objective of this study was to examine the accuracy of respiratory flow estimation algorithms during sleep: we investigated two approaches for calibrating the model parameters using the known data recorded during either wakefulness or sleep. The results show that the acoustical respiratory flow estimation parameters change from wakefulness to sleep. Therefore, if the model is calibrated using wakefulness data, although the estimated respiratory flow follows the relative variations of the real flow, the quantitative flow estimation error would be high during sleep. On the other hand, when the calibration parameters are extracted from tracheal sound and respiratory flow recordings during sleep, the respiratory flow estimation error is less than 10%.

Functional and histopathological identification of the respiratory failure in a DMSXL transgenic mouse model of myotonic dystrophy

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Petrica-Adrian Panaite

2013-05-01

Acute and chronic respiratory failure is one of the major and potentially life-threatening features in individuals with myotonic dystrophy type 1 (DM1. Despite several clinical demonstrations showing respiratory problems in DM1 patients, the mechanisms are still not completely understood. This study was designed to investigate whether the DMSXL transgenic mouse model for DM1 exhibits respiratory disorders and, if so, to identify the pathological changes underlying these respiratory problems. Using pressure plethysmography, we assessed the breathing function in control mice and DMSXL mice generated after large expansions of the CTG repeat in successive generations of DM1 transgenic mice. Statistical analysis of breathing function measurements revealed a significant decrease in the most relevant respiratory parameters in DMSXL mice, indicating impaired respiratory function. Histological and morphometric analysis showed pathological changes in diaphragmatic muscle of DMSXL mice, characterized by an increase in the percentage of type I muscle fibers, the presence of central nuclei, partial denervation of end-plates (EPs and a significant reduction in their size, shape complexity and density of acetylcholine receptors, all of which reflect a possible breakdown in communication between the diaphragmatic muscles fibers and the nerve terminals. Diaphragm muscle abnormalities were accompanied by an accumulation of mutant DMPK RNA foci in muscle fiber nuclei. Moreover, in DMSXL mice, the unmyelinated phrenic afferents are significantly lower. Also in these mice, significant neuronopathy was not detected in either cervical phrenic motor neurons or brainstem respiratory neurons. Because EPs are involved in the transmission of action potentials and the unmyelinated phrenic afferents exert a modulating influence on the respiratory drive, the pathological alterations affecting these structures might underlie the respiratory impairment detected in DMSXL mice. Understanding

Sound stabilizes locomotor-respiratory coupling and reduces energy cost.

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Charles P Hoffmann

Full Text Available A natural synchronization between locomotor and respiratory systems is known to exist for various species and various forms of locomotion. This Locomotor-Respiratory Coupling (LRC is fundamental for the energy transfer between the two subsystems during long duration exercise and originates from mechanical and neurological interactions. Different methodologies have been used to compute LRC, giving rise to various and often diverging results in terms of synchronization, (de-stabilization via information, and associated energy cost. In this article, the theory of nonlinear-coupled oscillators was adopted to characterize LRC, through the model of the sine circle map, and tested it in the context of cycling. Our specific focus was the sound-induced stabilization of LRC and its associated change in energy consumption. In our experimental study, participants were instructed during a cycling exercise to synchronize either their respiration or their pedaling rate with an external auditory stimulus whose rhythm corresponded to their individual preferential breathing or cycling frequencies. Results showed a significant reduction in energy expenditure with auditory stimulation, accompanied by a stabilization of LRC. The sound-induced effect was asymmetrical, with a better stabilizing influence of the metronome on the locomotor system than on the respiratory system. A modification of the respiratory frequency was indeed observed when participants cycled in synchrony with the tone, leading to a transition toward more stable frequency ratios as predicted by the sine circle map. In addition to the classical mechanical and neurological origins of LRC, here we demonstrated using the sine circle map model that information plays an important modulatory role of the synchronization, and has global energetic consequences.

46 CFR 197.550 - Respiratory protection.

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2010-10-01

... 46 Shipping 7 2010-10-01 2010-10-01 false Respiratory protection. 197.550 Section 197.550 Shipping... GENERAL PROVISIONS Benzene § 197.550 Respiratory protection. (a) General. When the use of respirators in... section that is appropriate for the exposure. Table 197.550(b)—Respiratory Protection for Benzene Airborne...

Treatment Failure and Mortality amongst Children with Severe Acute Malnutrition Presenting with Cough or Respiratory Difficulty and Radiological Pneumonia

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Chisti, Mohammod Jobayer; Salam, Mohammed Abdus; Bardhan, Pradip Kumar; Faruque, Abu S. G.; Shahid, Abu S. M. S. B.; Shahunja, K. M.; Das, Sumon Kumar; Hossain, Md Iqbal; Ahmed, Tahmeed

2015-01-01

Background Appropriate intervention is critical in reducing deaths among under-five, severe acutely malnourished (SAM) children with danger signs of severe pneumonia; however, there is paucity of data on outcome of World Health Organisation (WHO) recommended interventions of SAM children with severe pneumonia. We sought to evaluate outcome of the interventions in such children. Methods We prospectively enrolled SAM children aged 0–59 months, admitted to the Intensive Care Unit (ICU) or Acute Respiratory Infection (ARI) ward of the Dhaka Hospital of the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), between April 2011 and June 2012 with cough or respiratory difficulty and radiological pneumonia. All the enrolled children were treated with ampicillin and gentamicin, and micronutrients as recommended by the WHO. Comparison was made among pneumonic children with (n = 111) and without WHO defined danger signs of severe pneumonia (n = 296). The outcomes of interest were treatment failure (if a child required changing of antibiotics) and deaths during hospitalization. Further comparison was also made among those who developed treatment failure and who did not and among the survivors and deaths. Results SAM children with danger signs of severe pneumonia more often experienced treatment failure (58% vs. 20%; ppp<0.01). Conclusion and Significance The result suggests that SAM children with cough or respiratory difficulty and radiologic pneumonia who had WHO-defined danger signs of severe pneumonia more often had treatment failure and fatal outcome compared to those without the danger signs. In addition to danger signs of severe pneumonia, other common causes of both treatment failure and deaths were dehydration, hypocalcaemia, and bacteraemia on admission. The result underscores the importance for further research especially a randomized, controlled clinical trial to validate standard WHO therapy in SAM children with pneumonia especially with

Air pollution and multiple acute respiratory outcomes.

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Faustini, Annunziata; Stafoggia, Massimo; Colais, Paola; Berti, Giovanna; Bisanti, Luigi; Cadum, Ennio; Cernigliaro, Achille; Mallone, Sandra; Scarnato, Corrado; Forastiere, Francesco

2013-08-01

Short-term effects of air pollutants on respiratory mortality and morbidity have been consistently reported but usually studied separately. To more completely assess air pollution effects, we studied hospitalisations for respiratory diseases together with out-of-hospital respiratory deaths. A time-stratified case-crossover study was carried out in six Italian cities from 2001 to 2005. Daily particulate matter (particles with a 50% cut-off aerodynamic diameter of 10 μm (PM10)) and nitrogen dioxide (NO2) associations with hospitalisations for respiratory diseases (n = 100 690), chronic obstructive pulmonary disease (COPD) (n = 38 577), lower respiratory tract infections (LRTI) among COPD patients (n = 9886) and out-of-hospital respiratory deaths (n = 5490) were estimated for residents aged ≥35 years. For an increase of 10 μg·m(-3) in PM10, we found an immediate 0.59% (lag 0-1 days) increase in hospitalisations for respiratory diseases and a 0.67% increase for COPD; the 1.91% increase in LRTI hospitalisations lasted longer (lag 0-3 days) and the 3.95% increase in respiratory mortality lasted 6 days. Effects of NO2 were stronger and lasted longer (lag 0-5 days). Age, sex and previous ischaemic heart disease acted as effect modifiers for different outcomes. Analysing multiple rather than single respiratory events shows stronger air pollution effects. The temporal relationship between the pollutant increases and hospitalisations or mortality for respiratory diseases differs.

Epidemiology of respiratory pathogen carriage in the homeless population within two shelters in Marseille, France, 2015-2017: cross sectional 1-day surveys.

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Ly, T D A; Edouard, S; Badiaga, S; Tissot-Dupont, H; Hoang, V T; Pommier de Santi, V; Brouqui, P; Raoult, D; Gautret, P

2018-05-17

To assess risk factors for respiratory tract infection symptoms and signs in sheltered homeless people in Marseille during the winter season, including pathogen carriage. Data on 479 male participants within two shelters who completed questionnaires and a total of 950 nasal and pharyngeal samples were collected during the winters of 2015-2017. Respiratory pathogen carriage including seven viruses and four bacteria was assessed by quantitative PCR. The homeless population was characterized by a majority of individuals of North African origin (300/479, 62.6%) with a relatively high prevalence of chronic homelessness (175/465, 37.6%). We found a high prevalence of respiratory symptoms and signs (168/476, 35.3%), a very high prevalence of bacterial carriage (313/477, 65.6%), especially Haemophilus influenzae (280/477, 58.7%), and a lower prevalence of virus carriage (51/473, 10.8%) with human rhinovirus being the most frequent (25/473, 5.3%). Differences were observed between the microbial communities of the nose and throat. Duration of homelessness (odds ratio (OR) 1.77, p 0.017), chronic respiratory diseases (OR 5.27, p respiratory symptoms and signs. A strong association between virus (OR 2.40, p 0.012) or Streptococcus pneumoniae (OR 2.32, p 0.014) carriage and respiratory symptoms and signs was also found. These findings allowed identification of the individuals at higher risk for contracting respiratory tract infections to better target preventive measures aimed at limiting the transmission of these diseases in this setting. Copyright © 2018 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.