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Sample records for respiratory symptoms cough

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

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

    2006-03-01

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

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

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

    2006-01-01

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

  3. The psychometric properties of the Leicester Cough Questionnaire and Respiratory Symptoms in CF tool in cystic fibrosis: A preliminary study.

    Ward, Nathan; Stiller, Kathy; Rowe, Hilary; Holland, Anne E

    2017-05-01

    There are few tools to quantify the impact of cough in cystic fibrosis (CF). The psychometric properties of the Leicester Cough Questionnaire (LCQ) and Respiratory Symptoms in CF (ReS-CF) tool were investigated in adults with CF. Validity and reliability were assessed in clinically stable participants who completed the questionnaires twice, along with the Cystic Fibrosis Questionnaire - Revised (CFQ-R). Responsiveness was assessed by change in questionnaires following treatment for an acute respiratory exacerbation. Correlations between the LCQ and CFQ-R respiratory domain were moderate (n=59, r s =0.78, p<0.001). Correlations between ReS-CF and CFQ-R respiratory domain were fair (r s =-0.50, p<0.001). The LCQ total score was repeatable (ICC 0.92, 95%CI 0.87-0.96, n=50). In those reporting improvement in symptoms following treatment (n=36), LCQ total score had a mean change of 4.6 (SD 3.7) and effect size of 1.2. The LCQ and ReS-CF appear to be valid, reliable and responsive in CF. www.anzctr.org.au: ACTRN12615000262505. Copyright © 2016 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.

  4. Respiratory symptoms of megaesophagus

    Fabio Di Stefano

    2013-03-01

    Full Text Available Megaesophagus as the end result of achalasia is the consequence of disordered peristalsis and the slow decompensation of the esophageal muscular layer. The main symptoms of achalasia are dysphagia, regurgitation, chest pain and weight loss, but respiratory symptoms, such as coughing, particularly when patients lie in a horizontal position, may also be common due to microaspiration. A 70-year old woman suffered from a nocturnal cough and shortness of breath with stridor. She reported difficulty in swallowing food over the past ten years, but had adapted by eating a semi-liquid diet. Chest X-ray showed right hemithorax patchy opacities projecting from the posterior mediastinum. Chest computed tomography scan showed a marked dilatation of the esophagus with abundant food residues. Endoscopy confirmed the diagnosis of megaesophagus due to esophageal achalasia, excluding other causes of obstruction, such as secondary esophagitis, polyps, leiomyoma or leiomyosarcoma. In the elderly population, swallowing difficulties due to esophageal achalasia are often underestimated and less troublesome than the respiratory symptoms that are caused by microaspiration. The diagnosis of esophageal achalasia, although uncommon, should be considered in patients with nocturnal chronic coughs and shortness of breath with stridor when concomitant swallowing difficulties are present.

  5. Fabry disease, respiratory symptoms, and airway limitation

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

    2015-01-01

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

  6. High frequency analysis of cough sounds in pediatric patients with respiratory diseases.

    Kosasih, K; Abeyratne, U R; Swarnkar, V

    2012-01-01

    Cough is a common symptom in a range of respiratory diseases and is considered a natural defense mechanism of the body. Despite its critical importance in the diagnosis of illness, there are no golden methods to objectively assess cough. In a typical consultation session, a physician may briefly listen to the cough sounds using a stethoscope placed against the chest. The physician may also listen to spontaneous cough sounds via naked ears, as they naturally propagate through air. Cough sounds carry vital information on the state of the respiratory system but the field of cough analysis in clinical medicine is in its infancy. All existing cough analysis approaches are severely handicapped by the limitations of the human hearing range and simplified analysis techniques. In this paper, we address these problems, and explore the use of frequencies covering a range well beyond the human perception (up to 90 kHz) and use wavelet analysis to extract diagnostically important information from coughs. Our data set comes from a pediatric respiratory ward in Indonesia, from subjects diagnosed with asthma, pneumonia and rhinopharyngitis. We analyzed over 90 cough samples from 4 patients and explored if high frequencies carried useful information in separating these disease groups. Multiple regression analysis resulted in coefficients of determination (R(2)) of 77-82% at high frequencies (15 kHz-90 kHz) indicating that they carry useful information. When the high frequencies were combined with frequencies below 15kHz, the R(2) performance increased to 85-90%.

  7. Airway Reflux, Cough and Respiratory Disease

    Molyneux, Ian D.; Morice, Alyn H.

    2011-01-01

    It is increasingly accepted that the effects of gastro-oesophageal reflux are not limited to the gastrointestinal tract. The adjacent respiratory structures are also at risk from material ejected from the proximal oesophagus as a result of the failure of anatomical and physiological barriers. There is evidence of the influence of reflux on several respiratory and otorhinological conditions and although in many cases the precise mechanism has yet to be elucidated, the association alone opens potential novel avenues of therapy to clinicians struggling to treat patients with apparently intractable respiratory complaints. This review provides a description of the airway reflux syndrome, its effects on the lung and current and future therapeutic options. PMID:23251752

  8. Characterization of urge to cough and cough symptoms associated with the common cold: results of a US internet survey.

    Eccles, Ron; Dicpinigaitis, Peter; Turner, Ronald B; Druce, Howard M; Adeleke, Maryann; Mann, Ashley L

    2016-06-01

    Our knowledge of cough physiology is limited despite years of study. Even less is known about the sensation of urge to cough. Given that limited clinical data are available about urge to cough and cough attributes during a common cold, we sought to gain insights into experiences and perceptions related to these symptoms. An internet survey consisting of 51 questions was fielded in the United States. Eligible survey participants included men and women aged 18 years and older who had suffered from a cold with cough within the three months preceding the survey. Participants who confirmed suffering from recurrent cough, asthma, chronic bronchitis, chronic obstructive pulmonary disease, cystic fibrosis, or gastrointestinal reflux were excluded. Of 19,530 initial respondents, 8011 had a cold in the past three months. Of these, 6484 (81%) had experienced cough symptoms; 2708 respondents with cough due to cold and no exclusionary condition made up the analysis sample. Most respondents (62%) reported that cough developed one to two days after the onset of cold symptoms, and 45% felt that cough worsened their other cold symptoms. In 69% of respondents, cough outlasted other cold symptoms. Urge to cough was reported by 98% of respondents, and among these respondents, 64% described it as uncontrollable and 65% rated severity as moderate. More than half of respondents (57%) considered the sensation of urge to cough and the act of coughing as equally bothersome. Although urge to cough and inability to control cough were the most bothersome aspects of cough due to cold, few (<20%) respondents asked healthcare providers for treatment recommendations. Symptoms of urge to cough and cough are common and have a significant impact on cold sufferers. Understanding attributes of these symptoms may provide insights for effective management and the development of novel treatment strategies.

  9. Symptom research on chronic cough: a historical perspective.

    Irwin, R S; Madison, J M

    2001-05-01

    This review provides a perspective on how research on the management of cough has evolved, looks at key methodologic lessons that have been learned from this research and how they may relate to the management of other symptoms, identifies important methodologic challenges that remain to be solved, and lists important questions that still need to be answered. Three important methodologic lessons have been learned. First, cough must be evaluated systematically and according to a neuroanatomic framework. Second, the response to specific therapy must be noted to determine the cause or causes of cough and to characterize the strengths and limitations of diagnostic testing. Third, multiple conditions can simultaneously cause cough. Among the three methodologic challenges that still need to be solved are 1) definitively determining the diagnostic accuracy and reliability of 24-hour esophageal pH monitoring and how best to interpret pH test results, 2) definitively determining the role of nonacid reflux in cough due to gastroesophageal reflux disease, and 3) developing reliable and reproducible subjective and objective methods with which to assess the efficacy of cough therapy. Numerous important clinical questions are still unanswered: What role do empirical therapeutic trials play in diagnosing the cause of chronic cough? What is the most cost-effective approach to the diagnosis and treatment of chronic cough: empirical therapeutic trials or laboratory testing-directed therapeutic trials? How often is environmental air pollution, unrelated to allergies or smoking, responsible for chronic cough?

  10. Effects of quitting cannabis on respiratory symptoms

    Hancox, Robert J.; Shin, Hayden H.; Gray, Andrew R.; Poulton, Richie; Sears, Malcolm R.

    2016-01-01

    Smoking cannabis is associated with symptoms of bronchitis. Little is known about the persistence of symptoms after stopping cannabis use. We assessed associations between changes in cannabis use and respiratory symptoms in a population-based cohort of 1037 young adults. Participants were asked about cannabis and tobacco use at ages 18, 21, 26, 32 and 38 years. Symptoms of morning cough, sputum production, wheeze, dyspnoea on exertion and asthma diagnoses were ascertained at the same ages. Frequent cannabis use was defined as ≥52 occasions over the previous year. Associations between frequent cannabis use and respiratory symptoms were analysed using generalised estimating equations with adjustments for tobacco smoking, asthma, sex and age. Frequent cannabis use was associated with morning cough (OR 1.97, pcannabis use was associated with reductions in the prevalence of cough, sputum and wheeze to levels similar to nonusers. Frequent cannabis use is associated with symptoms of bronchitis in young adults. Reducing cannabis use often leads to a resolution of these symptoms. PMID:25837035

  11. Respiratory Symptoms in Firefighters

    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

  12. Long-lasting cough in an adult German population: incidence, symptoms, and related pathogens.

    Weinberger, Raphael; Riffelmann, Marion; Kennerknecht, Nicole; Hülße, Christel; Littmann, Martina; O'Brien, Judith; von Kries, Rüdiger; von König, Carl Heinz Wirsing

    2018-04-01

    Studies of the incidence of pertussis in adults have shown that it accounts for only 5-15% cases of prolonged coughing. We assessed the burden of suffering related to prolonged coughing and tried to identify further causative agents. Based on a sentinel study with 35 general practitioners in two German cities (Krefeld, Rostock), with 3,946 patients fulfilling the inclusion criteria, we estimated the incidence of prolonged coughing in adults. In 975 of these outpatients, PCR and/or serology for adenovirus, Bordetella pertussis and B. parapertussis, human metapneumovirus, influenza virus A and rhinovirus, parainfluenza virus, Mycoplasma pneumonia, and respiratory syncytial virus (RSV) were performed. Treatment data were extracted for a subgroup of 138 patients. Descriptive statistics, including Kaplan-Maier curves were generated. Yearly incidence ranged between 1.4 and 2.1% per population in the two cities. Adult patients sought medical attention only after a median of 3 weeks of coughing. Irrespective of smoking and unrelated to the identified pathogens, the median duration of coughing was 6 weeks, with an interquartile range of 4-11 weeks. In 48.3% of patients, possible pathogens were identified, among which adenovirus (15.1%), RSV (7.5%), B. pertussis (5.6%), and influenza viruses (4.0%) were most often found. Symptoms were not indicative of a specific agent and a total of 64% of patients received antibiotics. Prolonged adult coughing requiring medical attention prompts substantial healthcare use. Apart from B. pertussis, a broad range of pathogens was associated with the symptoms. However, patients sought medical attention too late to guide efficacious therapeutic interventions using the diagnostic tests.

  13. Determinants of Chronic Respiratory Symptoms among Pharmaceutical Factory Workers

    Sahle Asfaw

    2018-01-01

    Full Text Available Background. Chronic respiratory symptoms including chronic cough, chronic phlegm, wheezing, shortness of breath, and chest pain are manifestations of respiratory problems which are mainly evolved as a result of occupational exposures. This study aims to assess determinants of chronic respiratory symptoms among pharmaceutical factory workers. Methods. A case control study was carried out among 453 pharmaceutical factory workers with 151 cases and 302 controls. Data was collected using pretested and structured questionnaire. The data was analyzed using descriptive statistics and bivariate and multivariate analysis. Result. Previous history of chronic respiratory diseases (AOR = 3.36, 95% CI = 1.85–6.12, family history of chronic respiratory diseases (AOR = 2.55, 95% CI = 1.51–4.32, previous dusty working environment (AOR = 2.26, 95% CI = 1.07–4.78, ever smoking (AOR = 3.66, 95% CI = 1.05–12.72, and service years (AOR = 1.86, 95% CI = 1.16–2.99 showed statistically significant association with chronic respiratory symptoms. Conclusion. Previous history of respiratory diseases, family history of chronic respiratory diseases, previous dusty working environment, smoking, and service years were determinants of chronic respiratory symptoms. Public health endeavors to prevent the burden of chronic respiratory symptoms among pharmaceutical factory workers should target the reduction of adverse workplace exposures and discouragement of smoking.

  14. Cough aerosol in healthy participants: fundamental knowledge to optimize droplet-spread infectious respiratory disease management.

    Zayas, Gustavo; Chiang, Ming C; Wong, Eric; MacDonald, Fred; Lange, Carlos F; Senthilselvan, Ambikaipakan; King, Malcolm

    2012-03-21

    The Influenza A H1N1 virus can be transmitted via direct, indirect, and airborne route to non-infected subjects when an infected patient coughs, which expels a number of different sized droplets to the surrounding environment as an aerosol. The objective of the current study was to characterize the human cough aerosol pattern with the aim of developing a standard human cough bioaerosol model for Influenza Pandemic control. 45 healthy non-smokers participated in the open bench study by giving their best effort cough. A laser diffraction system was used to obtain accurate, time-dependent, quantitative measurements of the size and number of droplets expelled by the cough aerosol. Voluntary coughs generated droplets ranging from 0.1 - 900 microns in size. Droplets of less than one-micron size represent 97% of the total number of measured droplets contained in the cough aerosol. Age, sex, weight, height and corporal mass have no statistically significant effect on the aerosol composition in terms of size and number of droplets. We have developed a standard human cough aerosol model. We have quantitatively characterized the pattern, size, and number of droplets present in the most important mode of person-to-person transmission of IRD: the cough bioaerosol. Small size droplets (< 1 μm) predominated the total number of droplets expelled when coughing. The cough aerosol is the single source of direct, indirect and/or airborne transmission of respiratory infections like the Influenza A H1N1 virus. Open bench, Observational, Cough, Aerosol study. © 2012 Zayas et al; licensee BioMed Central Ltd.

  15. Respiratory symptoms and functions in barn workers

    Ege Gulec Balbay

    2014-03-01

    Full Text Available Introduction and aim. The presented study was undertaken to investigate the respiratory health problems in family barns with one or more cows and at least one family member working in the barn. Methods. 150 workers (128 female, 22 male from 4 villages of Yığılca district near the city of Düzce in north-west Turkey were enrolled in this study between October – December 2011. An Occupational and Environmental Chest Diseases questionnaire developed by the American Thoracic Society, pulmonary function test, physical examination and investigation for nasal eosinophil were performed in all subjects. Results. The mean age of workers was 47.7 ± 14.2 years. Cough was present in 24% of subjects. The rates of phlegm, wheezing, chest tightness and dyspnea were 13.3%, 6%, 6% and 27.3%, respectively. Obstructive ventilatory pattern was observed in 37 workers (24.6%. 43 workers (28.6% showed restrictive ventilatory pattern. Nasal eosinophilia was detected in 47.3% (71/150 of the subjects. Pulmonary functions of workers with nasal eosinophilia did not differ from the other workers. There were statistically significant negative correlations between the duration of working in barns and respiratory functions. Conclusions. Pulmonary functions of barn workers have been found to be decreased related to the duration of barn working. Furthermore, respiratory symptoms increased in relation with both barn working and biomass consumption. Precautions should therefore be taken to ventilate both barns and houses.

  16. RESPIRATORY SYMPTOMS AND SMOKING HABITS OF SENIOR INDUSTRIAL STAFF

    Meadows, Susan H.; Wood, C. H.; Schilling, R. S. F.

    1965-01-01

    The prevalence of respiratory symptoms and the smoking habits of 224 industrial `executives' aged 30 to 69 years in Social Classes I and II were ascertained by means of the Medical Research Council's questionnaire on respiratory symptoms; 31% had persistent cough, 25% had persistent phlegm, and 21% were short of breath on hurrying or going up a hill; 9% had had one or more chest illnesses in the past three years lasting for about a week, and 4% had `chronic bronchitis'—defined as persistent phlegm and one or more chest illnesses in the past three years; 67% were smokers, 21% smoking more than 25 cigarettes (or equivalent tobacco) per day; another 20% had stopped smoking. The prevalence of cough, phlegm, and breathlessness was closely related to smoking habit. Data for those aged 40 to 59 years are compared with that obtained from London Transport Board workers and a sample of the population studied by the College of General Practitioners. The latter was further analysed and suggests that the prevalence of cough and phlegm is more closely related to the amount smoked than to social class. The prevalence of chest illness is probably more closely related to social class and less to the amount smoked. It is suggested that, although smoking may initiate irritative respiratory symptoms, the precursors of bronchitis, additional factors are important in causing progression to disabling or fatal chronic bronchitis. PMID:14278803

  17. Respiratory symptoms in insect breeders.

    Harris-Roberts, J; Fishwick, D; Tate, P; Rawbone, R; Stagg, S; Barber, C M; Adisesh, A

    2011-08-01

    A number of specialist food suppliers in the UK breed and distribute insects and insect larvae as food for exotic pets, such as reptiles, amphibians and invertebrates. To investigate the extent of work-related (WR) symptoms and workplace-specific serum IgE in workers potentially exposed to a variety of biological contaminants, including insect and insect larvae allergens, endotoxin and cereal allergens at a UK specialist insect breeding facility. We undertook a study of respiratory symptoms and exposures at the facility, with subsequent detailed clinical assessment of one worker. All 32 workers were assessed clinically using a respiratory questionnaire and lung function. Eighteen workers consented to provide serum for determination of specific IgE to workplace allergens. Thirty-four per cent (11/32) of insect workers reported WR respiratory symptoms. Sensitization, as judged by specific IgE, was found in 29% (4/14) of currently exposed workers. Total inhalable dust levels ranged from 1.2 to 17.9 mg/m(3) [mean 4.3 mg/m(3) (SD 4.4 mg/m(3)), median 2.0 mg/m(3)] and endotoxin levels of up to 29435 EU/m(3) were recorded. Exposure to organic dusts below the levels for which there are UK workplace exposure limits can result in respiratory symptoms and sensitization. The results should alert those responsible for the health of similarly exposed workers to the potential for respiratory ill-health and the need to provide a suitable health surveillance programme.

  18. The relationship between host factors of allergic nature and respiratory symptoms.

    Gepts, L; Minette, A

    1977-01-01

    Respiratory symptoms and personal history of allergy were examined in 1659 children, including the entire elementary school population of four villages of the Belgian Ardennes. Levels of atmospheric pollution were monitored during the survey and proved to be very low. It is suggested that socio-economic factors produce a small increase in respiratory symptoms, particularly in cough symptoms. A personal history of eczema and of hay fever was highly associated with dyspnea and wheezing.

  19. Classification of voluntary coughs applied to the screening of respiratory disease.

    Infante, Christian; Chamberlain, Daniel B; Kodgule, Rahul; Fletcher, Richard Ribon

    2017-07-01

    Pulmonary and respiratory diseases (e.g. asthma, COPD, allergies, pneumonia, tuberculosis, etc.) represent a large proportion of the global disease burden, mortality, and disability. In this context of creating automated diagnostic tools, we explore how the analysis of voluntary cough sounds may be used to screen for pulmonary disease. As a clinical study, voluntary coughs were recorded using a custom mobile phone stethoscope from 54 patients, of which 7 had COPD, 15 had asthma, 11 had allergic rhinitis, 17 had both asthma and allergic rhinitis, and four had both COPD and allergic rhinitis. Data were also collected from 33 healthy subjects. These patients also received full auscultation at 11 sites, given a clinical questionnaire, and underwent full pulmonary function testing (spirometer, body plethysmograph, DLCO) which culminated in a diagnosis provided by an experienced pulmonologist. From machine learning analysis of these data, we show that it is possible to achieve good classification of cough sounds in terms of Wet vs Dry, yielding an ROC curve with AUC of 0.94, and show that voluntary coughs can serve as an effective test for determining Healthy vs Unhealthy (sensitivity=35.7% specificity=100%). We also show that the use of cough sounds can enhance the performance of other diagnostic tools such as a patient questionnaire and peak flow meter; however voluntary coughs alone provide relatively little value in determining specific disease diagnosis.

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

    Mats eBende

    2012-07-01

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

  1. The capsaicin cough reflex in patients with symptoms elicited by odorous chemicals

    Holst, H; Arendt-Nielsen, L; Mosbech, H

    2010-01-01

    Patients with multiple chemical sensitivity and eczema patients with airway symptoms elicited by odorous chemicals have enhanced cough reflex to capsaicin when applying the tidal breathing method. The aims of the present study were to test whether the capsaicin induced cough reflex was enhanced...... when applying the single breath inhalation method in similar groups of patients with symptoms related to odorous chemicals e.g. other persons wearing of perfume; and to investigate to what extent the reporting of lower airway symptoms influenced the cough reflex. Sixteen patients fulfilling Cullen......'s criteria for multiple chemical sensitivity and 15 eczema patients with airway symptoms elicited by odorous chemicals were compared with 29 age-matched, healthy controls. We measured C5--the capsaicin concentration causing five coughs or more--using the single breath inhalation test. No difference was found...

  2. Achalasia and Respiratory Symptoms: Effect of Laparoscopic Heller Myotomy.

    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.

  3. Improvement of respiratory symptoms following Heller myotomy for achalasia.

    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.

  4. Prevalence of Occupational Asthma and Respiratory Symptoms in Foundry Workers

    Servet Kayhan

    2013-01-01

    Full Text Available This cross-sectional study was conducted in a foundry factory to assess the prevalence of respiratory symptoms and occupational asthma in foundry workers. Physical examination, spirometric evaluation, chest radiograph, and a questionnaire related to respiratory symptoms were performed. Monitoring of peak expiratory flow rates, spirometric reversibility test, and high-resolution computed tomographies were performed for the participants having respiratory symptoms and/or impaired respiratory function test. A total of 347 participants including 286 workers from production department and 61 subjects who worked in nonproduction departments were enrolled in this study. It is found that phlegm (n: 71, 20.46% and cough (n: 52, 14.98% were the most frequent symptoms. The other symptoms were breathlessness (n: 28, 8.06%, chest tightness (n: 14, 4.03%, and wheezing (n: 7, 2.01% . The prevalence of occupational asthma was found to be more frequent among the subjects who worked in the production department (n: 48, 16.78% than the other persons who worked in the nonproduction department (n: 3, 4.91% by chi-square test (P: 0.001. To prevent hazardous respiratory effects of the foundry production, an early diagnosis of occupational asthma is very important. Cessation of cigarette smoking and using of protective masks during the working time should be encouraged.

  5. The effect of vocal fold augmentation on cough symptoms in the presence of glottic insufficiency.

    Litts, Juliana K; Fink, Daniel S; Clary, Matthew S

    2017-10-08

    To determine the effect of injection augmentation of the vocal folds on chronic cough symptoms in patients with glottic insufficiency. Medical records from 146 consecutive patients who underwent vocal fold injection augmentation by a fellowship-trained laryngologist between 2013 and 2015 were reviewed. Twenty-three patients (12 male) met inclusion criteria of a vocal fold augmentation injection, cough symptoms lasting more than 8 weeks, and glottic insufficiency as determined by shortened closed phase on stroboscopy. Exclusion criteria included lack of cough complaints, diagnosis of vocal fold immobility, previous history of vocal fold augmentation, and incomplete data sets. Data collected included age, gender, pre- and 1-month postinjection Cough Severity Index (CSI) scores, location of injection (unilateral or bilateral), and patient statement of percent change in symptoms that was recorded at 1-month postinjection visit. Paired t test indicated a significant decrease in CSI scores from pre- (m = 18.5) to 1-month postinjection (m = 12.1) (P = 0.004). Eighteen patients (78.2%) reported a 50% or greater improvement in cough symptoms at the 1-month postinjection visit. Injection augmentation of the vocal folds in the presence of glottic insufficiency appears to improve cough symptoms, as was reported by CSI in patients who are refractory to other medical and behavioral treatments. 4. Laryngoscope, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

  6. CERTAIN ASPECTS OF COUGH PATHOGENETIC THERAPY OF ACUTE CHILD RESPIRATORY INFECTIONS

    S.I. Bardenikova

    2008-01-01

    Full Text Available An open controlled comparative research was conducted on 263 children with acute respiratory infection (ARI in order to evaluate the clinical effectiveness, acceptability and safety of plant based preparation that contains ivy leaf extract. It was established that prescribing the preparation during the first days of disease reduced the duration of dry and inefficient cough, improved sputum rheology and bronchial tree drainage function, reduced bronchial obstruction intensity, reduced the need for prescribing bronchial spasmolitics less necessary and decreased Staybin term. Compared to other antibcough medicines, plant based preparation with ivy leaf extract has quicker effect (effective on the 1st–3rd day.Key words: children, acute respiratory infections, cough, treatment.

  7. The capsaicin cough reflex in patients with symptoms elicited by odorous chemicals

    Holst, H.; Arendt-Nielsen, Lars; Mosbech, H.

    2010-01-01

    between groups in age, body mass index or pulmonary function. The median C5 were 129 micromol/L (control group), 48 micromol/L (multiple chemical sensitivity patients), 32 micromol/L (eczema patients). The reporting of lower airway symptoms from odorous chemicals was significantly (p......Patients with multiple chemical sensitivity and eczema patients with airway symptoms elicited by odorous chemicals have enhanced cough reflex to capsaicin when applying the tidal breathing method. The aims of the present study were to test whether the capsaicin induced cough reflex was enhanced...... when applying the single breath inhalation method in similar groups of patients with symptoms related to odorous chemicals e.g. other persons wearing of perfume; and to investigate to what extent the reporting of lower airway symptoms influenced the cough reflex. Sixteen patients fulfilling Cullen...

  8. What is chronic cough in children?

    Iulia eIOAN

    2014-08-01

    Full Text Available The cough reflex is modulated throughout growth and development. Cough – but not expiration reflex – appears to be absent at birth, but increases with maturation. Thus, acute cough is the most frequent respiratory symptom during the first few years of life. Later on, the pubertal development seems to play a significant role in changing of the cough threshold during childhood and adolescence resulting in sex-related differences in cough reflex sensitivity in adulthood. Asthma is the major cause of chronic cough in children. Prolonged acute cough is usually related to the long-lasting effects of a previous viral airway infection or to the particular entity called protracted bacterial bronchitis. Cough pointers and type may orient towards specific aetiologies, such as barking cough in croup or tracheomalacia, paroxystic whooping cough in Pertussis. Cough is productive in protracted bacterial bronchitis, sinusitis or bronchiectasis. Cough is usually associated with wheeze or dyspnea on exertion in asthma; however, it may be the sole symptom in cough variant asthma. Thus, paediatric cough has particularities differentiating it from adult cough, so the approach and management should be developmentally specific.

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

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

    2006-01-01

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

  10. Respiratory and laryngeal symptoms secondary to gastro-oesophageal reflux

    Rafferty, G; Mainie, I; McGarvey, L P A

    2011-01-01

    Gastro-oesophageal reflux may cause a range of laryngeal and respiratory symptoms. Mechanisms responsible include the proximal migration of gastric refluxate beyond the upper oesophageal sphincter causing direct irritation of the larynx and lower airway. Alternatively, refluxate entering the distal oesophagus alone may stimulate oesophageal sensory nerves and indirectly activate airway reflexes such as cough and bronchospasm. Recognising reflux as a cause for these extraoesophageal symptoms can be difficult as many patients do not have typical oesophageal symptoms (eg, heartburn) and clinical findings on laryngoscopy are not very specific. Acid suppression remains an effective treatment in the majority of patients but there is growing appreciation of the need to consider and treat non-acid and volume reflux. New opinions about the role of existing medical and surgical (laparoscopic techniques) treatment are emerging and a number of novel anti-reflux treatments are under development. PMID:28839612

  11. Respiratory symptoms of vendors in an open-air hawker center in brunei darussalam.

    Nazurah Bt Abdul Wahid, Nurul Nor; Balalla, N B P; Koh, David

    2014-01-01

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

  12. Modulation of the cough reflex by GABAA receptors in the caudal ventral respiratory group of the rabbit

    Elenia eCinelli

    2012-10-01

    Full Text Available We have previously shown that the caudal ventral respiratory group (cVRG is a possible site of action of some antitussive drugs and plays a crucial role in determining both the expiratory and inspiratory components of the cough motor pattern. In addition, it has been reported that medullary expiratory neurons of the cVRG are subject to potent GABAergic gain modulation. This study was devoted to investigate the role of cVRG GABAA receptors in the control of baseline respiratory activity and cough responses to mechanical and chemical (citric acid stimulation of the tracheobronchial tree. To this purpose, bilateral microinjections (30-50 nl of bicuculline or muscimol were performed into the cVRG of pentobarbital sodium-anesthetized, spontaneously breathing rabbits. Bicuculline (1 mM increased peak abdominal activity and respiratory frequency due to decreases in TE. Cough responses were potentiated mainly owing to increases in the cough number. The recovery was observed within ~ 2 h. On the contrary, muscimol (0.3 mM abolished abdominal activity and decreased respiratory frequency due to increases in TE. In addition, cough responses were progressively reduced and completely suppressed within ~ 20 min. Partial recovery of cough responses was achieved after ~ 3 h or within ~ 5 min following bicuculline microinjections at the same locations. The sneeze reflex induced by mechanical stimulation of the nasal mucosa persisted following bicuculline and muscimol microinjections. However, the number and intensity of expiratory thrusts were enhanced by bicuculline and suppressed by muscimol. The results provide evidence that a potent GABAA-mediated inhibitory modulation is exerted at the level of the cVRG not only on respiratory activity, but also on cough and sneeze reflex responses.

  13. Lifestyle factors and contact to general practice with respiratory alarm symptoms

    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...

  14. Cooking fuel and respiratory symptoms among people living with HIV in rural Uganda

    Crystal M. North

    2017-05-01

    Full Text Available Household air pollution (HAP and chronic HIV infection are each associated with significant respiratory morbidity. Little is known about relationships between HAP and respiratory symptoms among people living with HIV. The objective of this study was to investigate the relationship between cooking fuel type and chronic respiratory symptoms in study participants from the Uganda AIDS Rural Treatment Outcomes Study. Study participants were enrolled at the time of antiretroviral therapy initiation and seen quarterly from 2005 to 2014 for health-focused questionnaires, CD4 count and HIV viral load. We used multivariable logistic regression and generalised estimating equations, with each study visit as a unit of observation, to investigate relationships between cooking fuel type and chronic respiratory symptoms. We observed an association between cooking with firewood (versus charcoal and chronic cough among HIV-infected females in rural Uganda (adjusted OR 1.41, 95% CI 1.00–1.99; p=0.047. We did not observe an association between cooking fuel type and respiratory symptoms among males (adjusted OR 0.88, 95% CI 0.47–1.63; p=0.658. Associations between cooking fuel and chronic cough in this HIV-infected cohort may be influenced by sex-based roles in meal preparation. This study raises important questions about relationships between household air pollution, HIV infection and respiratory morbidity.

  15. Respiratory Symptoms, Sleep, and Quality of Life in Patients With Advanced Lung Cancer.

    Lou, Vivian W Q; Chen, Elaine J; Jian, Hong; Zhou, Zhen; Zhu, Jingfen; Li, Guohong; He, Yaping

    2017-02-01

    Maintenance of quality of life and symptom management are important in lung cancer therapy. To the author's knowledge, the interplay of respiratory symptoms and sleep disturbance in affecting quality of life in advanced lung cancer remains unexamined. The study was designed to examine the relationships among respiratory symptoms, sleep disturbance, and quality of life in patients with advanced lung cancer. A total of 128 patients with advanced lung cancer (from chest oncology inpatient-units in Shanghai, China) participated in the study. They completed two questionnaires: the Functional Assessment of Cancer Therapy-Lung and the Pittsburgh Sleep Quality Index. Symptomatic breathing difficulty, coughing, shortness of breath, and tightness in the chest were reported in 78.1%, 70.3%, 60.9%, and 60.2% of the patients, respectively. Sleep disturbance affected 62.5% of the patients. The patients with severe respiratory symptoms were more likely to be poor sleepers and to have a lower quality of life. After the covariates were controlled for, regression analysis showed that respiratory symptoms and sleep disturbance were significant indicators of quality of life. In addition, some of the effect of the respiratory symptoms on quality of life was mediated by sleep disturbance. Respiratory symptoms and sleep disturbance were common in the advanced lung cancer patients and had a negative impact on their quality of life; sleep disturbance may mediate the relationship between respiratory symptoms and quality of life. Copyright © 2016 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  16. Respiratory Viruses in Febrile Neutropenic Patients with Respiratory Symptoms

    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.

  17. Respiratory viruses in airline travellers with influenza symptoms: Results of an airport screening study.

    Jennings, Lance C; Priest, Patricia C; Psutka, Rebecca A; Duncan, Alasdair R; Anderson, Trevor; Mahagamasekera, Patalee; Strathdee, Andrew; Baker, Michael G

    2015-06-01

    There is very little known about the prevalence and distribution of respiratory viruses, other than influenza, in international air travellers and whether symptom screening would aid in the prediction of which travellers are more likely to be infected with specific respiratory viruses. In this study, we investigate whether, the use of a respiratory symptom screening tool at the border would aid in predicting which travellers are more likely to be infected with specific respiratory viruses. Data were collected from travellers arriving at Christchurch International Airport, New Zealand, during the winter 2008, via a symptom questionnaire, temperature testing, and respiratory sampling. Respiratory viruses were detected in 342 (26.0%) of 1313 samples obtained from 2714 symptomatic travellers. The most frequently identified viruses were rhinoviruses (128), enteroviruses (77) and influenza B (48). The most frequently reported symptoms were stuffy or runny nose (60%), cough (47%), sore throat (27%) and sneezing (24%). Influenza B infections were associated with the highest number of symptoms (mean of 3.4) followed by rhinoviruses (mean of 2.2) and enteroviruses (mean of 1.9). The positive predictive value (PPV) of any symptom for any respiratory virus infection was low at 26%. The high prevalence of respiratory virus infections caused by viruses other than influenza in this study, many with overlapping symptotology to influenza, has important implications for any screening strategies for the prediction of influenza in airline travellers. Copyright © 2015 Elsevier B.V. All rights reserved.

  18. The deepwater horizon oil spill coast guard cohort study: A cross-sectional study of acute respiratory health symptoms.

    Alexander, Melannie; Engel, Lawrence S; Olaiya, Nathan; Wang, Li; Barrett, John; Weems, Laura; Schwartz, Erica G; Rusiecki, Jennifer A

    2018-04-01

    Over 8500 United States Coast Guard (USCG) personnel were deployed in response to the Deepwater Horizon (DWH) oil spill; however, human respiratory effects as a result of spill-related exposures are relatively unknown. USCG personnel who responded to the DWH oil spill were queried via survey on exposures to crude oil and oil dispersant, and acute respiratory symptoms experienced during deployment. Adjusted log binomial regressions were used to calculate prevalence ratios (PRs) and 95% confidence intervals (CI), investigating the associations between oil spill exposures and respiratory symptoms. 4855 USCG personnel completed the survey. More than half (54.6%) and almost one-fourth (22.0%) of responders were exposed to crude oil and oil dispersants, respectively. Coughing was the most prevalent symptom (19.4%), followed by shortness of breath (5.5%), and wheezing (3.6%). Adjusted analyses showed an exposure-response relationship between increasing deployment duration and likelihood of coughing, shortness of breath, and wheezing in the pre-capping period. A similar pattern was observed in the post-capping period for coughing and wheezing. Adjusted analyses revealed increased PRs for coughing (PR=1.92), shortness of breath (PR=2.60), and wheezing (PR=2.68) for any oil exposure. Increasing frequency of inhalation of oil was associated with increased likelihood of all three respiratory symptoms. A similar pattern was observed for contact with oil dispersants for coughing and shortness of breath. The combination of both oil and oil dispersants presented associations that were much greater in magnitude than oil alone for coughing (PR=2.72), shortness of breath (PR=4.65), and wheezing (PR=5.06). Results from the present study suggested strong relationships between oil and oil dispersant exposures and acute respiratory symptoms among disaster responders. Future prospective studies will be needed to confirm these findings. Copyright © 2017 Elsevier Inc. All rights reserved.

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

    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.

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

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

    2007-04-15

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

  1. Respiratory Symptoms and Pulmonary Function Impairment among ...

    Background: The industrial process of detergent production could be deleterious to lung function. This study describes respiratory symptoms and ventilatory function impairment among detergent workers in Jos, Northern Nigeria. Methods: Two hundred detergent plant workers and controls were studied for the presence of ...

  2. Longitudinal modelling of respiratory symptoms in children

    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

  3. The Clinical Value of Deflation Cough in Chronic Coughers With Reflux Symptoms.

    Lavorini, Federico; Chellini, Elisa; Bigazzi, Francesca; Surrenti, Elisabetta; Fontana, Giovanni A

    2016-06-01

    Patients with deflation cough (DC), the cough-like expulsive effort(s) evoked by maximal lung emptying during a slow vital capacity maneuver, also present symptoms of gastroesophageal reflux. DC can be inhibited by prior intake of antacids. We wished to assess DC prevalence and association between DC and chemical characteristics of refluxate in patients with gastroesophageal reflux symptoms. A total of 157 consecutive outpatients underwent DC assessment and 24-h multichannel intraluminal impedance pH (MII-pH) monitoring; 93/157 also had chronic cough. Patients performed two to four slow vital capacity maneuvers and DC was detected aurally. Subsequently, they underwent 24-h MII-pH monitoring, the outcomes of which were defined as abnormal when acid or non-acid reflux events were > 73. DC occurred in 46/157 patients, 18 of whom had abnormal MII-pH outcomes; 28 of the remaining 111 patients without DC also had abnormal MII-pH findings. Thus, in the patients as a group, there was no association between DC and MII-pH outcomes. DC occurred in 40/93 of the chronic coughers; 15 of whom had acid reflux. All but 2 of the 53 patients without DC had normal MII-pH outcomes (P < .001), and the negative predictive value of DC for excluding acid reflux was 96.2%. At follow-up, 65% of coughers showed significant improvement after treatment. The overall prevalence of DC was 29%, increasing to 43% in chronic coughers in whom the absence of DC virtually excludes acid reflux. Therefore, DC assessment may represent a useful screening test for excluding acid reflux in chronic coughers with reflux symptoms. Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

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

    Mirabelli Maria C

    2012-03-01

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

  5. Longitudinal association between respiratory muscle strength and cough capacity in persons with spinal cord injury: : An explorative analysis of data from a randomized controlled trial

    Postma, Karin; Vlemmix, Lonneke Y.; Haisma, Janneke A.; de Groot, Sonja; Sluis, Tebbe A. R.; Stam, Henk J.; Bussmann, Johannes B. J.

    Objective: To assess the longitudinal association between respiratory muscle strength and cough capacity in persons with recent spinal cord injury. Design: Longitudinal analyses. Subjects: Forty persons with recent spinal cord injury and impaired pulmonary function. Methods: Measurements were

  6. Cooking smoke and respiratory symptoms of restaurant workers in Thailand.

    Juntarawijit, Chudchawal; Juntarawijit, Yuwayong

    2017-02-17

    Restaurant workers are at risk from exposure to toxic compounds from burning of fuel and fumes from cooking. However, the literature is almost silent on the issue. What discussion that can be found in the literature focuses on the potential effects from biomass smoke exposure in the home kitchen, and does not address the problem as occurring in the workplace, particularly in restaurants. This was a cross-sectional survey of 224 worker from 142 food restaurants in the Tha Pho sub-district of Phitsanulok, a province in Thailand. The standard questionnaire from the British Medical Research Council was used to collect data on chronic respiratory symptoms, including cough, phlegm, dyspnea, severe dyspnea, stuffy nose in the participating workers. Data on their health symptoms experienced in the past 30 days was also asked. A constructed questionnaire was used to collect exposure data, including type of job, time in the kitchen, the frequency of frying food, tears while cooking (TWC), the type of restaurant, fuel used for cooking, the size and location of the kitchen, and the exhaust system and ventilation. The prevalence of the symptoms was compared with those obtained from 395 controls, who were neighbors of the participants who do not work in a restaurant. In comparison to the control group, the restaurant workers had twice or more the prevalence on most of the chronic health symptoms. Men had a higher risk for "dyspnea", "stuffy nose" and "wheeze" while women had higher risk of "cough". A Rate Ratio (RR) of susceptibility was established, which ranged from 1.4 up to 9.9. The minimum RR was for women with "severe dyspnea" (RR of 1.4, 95%CI 0.8, 2.5) while the men showed the maximum RR of 9.9 (95%CI 4.5-22.0) for "wheeze". Possible risk factors identified were job description, job period, size of restaurant, kitchen location, type of cooking oil, hours of stay in the kitchen area, number of fry dishes prepared, frequency of occurrence of TWC, and additional cooking at

  7. Perception of urge-to-cough and dyspnea in healthy smokers with decreased cough reflex sensitivity

    Kanezaki, Masashi; Ebihara, Satoru; Nikkuni, Etsuhiro; Gui, Peijun; Suda, Chihiro; Ebihara, Takae; Yamasaki, Miyako; Kohzuki, Masahiro

    2010-01-01

    Background Although cigarette smoking has been implicated as an important risk factor for the development of respiratory symptoms, the perceptional aspects of two symptoms in smokers have not been fully elucidated. Therefore, we simultaneously evaluated the cough reflex sensitivity, the cognition of urge-to-cough and perception of dyspnea in both healthy smokers and non-smokers. Methods Fourteen male healthy never-smokers and 14 age-matched male healthy current-smokers were recruited via publ...

  8. High rates of respiratory symptoms and airway disease in mental health inpatients in a tertiary centre.

    Burke, Andrew J; Hay, Karen; Chadwick, Alex; Siskind, Dan; Sheridan, Judith

    2018-04-01

    People with severe mental illness (SMI) have a lower life expectancy due in part to a higher prevalence of cardiac and metabolic disease. Less is known of the prevalence of respiratory disease in this group. This cross-sectional, observational study aimed to assess the prevalence of symptoms associated with respiratory disease in patients admitted to an inpatient mental health unit. A convenience sample of 82 inpatients had a structured interview and questionnaire completed. The questionnaire included self-reported diagnoses of common diseases and screening questions designed to detect respiratory disease and sleep disordered breathing. Targeted spirometry was performed on the basis of symptoms and smoking status. Patients reported high rates of respiratory symptoms, including wheezing (38%) and dyspnoea (44%); 52% of patients reported daily tobacco use. Productive cough was significantly associated with tobacco use (P disease (COPD) of whom six did not have a formal diagnosis of COPD previously. People with SMI have high rates of respiratory symptoms with a high prevalence of COPD on spirometry. Half of the COPD cases were not previously diagnosed, suggesting a hidden burden of respiratory disease in patients with SMI. © 2017 Royal Australasian College of Physicians.

  9. Theory and Application of Audio-Based Assessment of Cough

    Yan Shi

    2018-01-01

    Full Text Available Cough is a common symptom of many respiratory diseases. Many medical literatures underline that a system for the automatic, objective, and reliable detection of cough events is important and very promising to detect pathology severity in chronic cough disease. In order to track the development status of an audio-based cough monitoring system, we briefly described the history of objective cough detection and then illustrated the cough sound generating principle. The probable endpoints of cough clinical studies, including cough frequency, intensity of coughing, and acoustic properties of cough sound, were analyzed in this paper. Finally, we introduce some successful cough monitoring equipment and their recognition algorithm in detail. It can be obtained that, firstly, acoustic variability of cough sounds within and between individuals makes it difficult to assess the intensity of coughing. Furthermore, now great progress in audio-based cough detection is being made. Moreover, accurate portable objective monitoring systems will be available and widely used in home care and clinical trials in the near future.

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

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

    2008-01-01

    . Determinants for respiratory symptoms were increasing age, winter season, household size, size of residence, day-care attendance, and having siblings aged 1-3 years attending a day nursery. In conclusion, the present study provides detailed data on the occurrence of disease symptoms during the first year......Respiratory symptoms are common in infancy. Most illnesses occurring among children are dealt with by parents and do not require medical attention. Nevertheless, few studies have prospectively and on a community-basis assessed the amount of respiratory symptoms and general illness in normal infants...... out by multiple logistic regression analysis. On average, children had general symptoms for 3.5 months during their first year of life, nasal discharge being most frequent followed by cough. Frequency of all symptoms increased steeply after 6 months of age. Each child had on average 6.3 episodes...

  11. Longitudinal changes in prevalence of respiratory symptoms among Canadian grain elevator workers.

    Pahwa, Punam; McDuffie, Helen H; Dosman, James A

    2006-06-01

    To determine longitudinal changes in the prevalence of chronic respiratory symptoms among Canadian grain workers. Data on respiratory symptoms, smoking status, and pulmonary function were obtained approximately every 3 years (termed cycle) over 15 years beginning in 1978 from five regions of Canada. The number of grain workers participating in each cycle were as follows: cycle 1 (n = 5,702); cycle 2 (n = 5,491); cycle 3 (n = 3,713); cycle 4 (n = 2,847); and cycle 5 (n = 3,079). A procedure based on generalized estimating equations (PROC GENMOD; SAS Institute; Cary, NC) was used to fit marginal models to determine risk factors influencing the prevalence of chronic respiratory symptoms (wheeze, dyspnea, sputum, and cough). The prevalence (predicted probability based on the final model) of chronic respiratory symptoms had an increasing trend with increasing number of years in the grain industry from cycle 1 to cycle 3 (before dust control) for all three smoking categories (current smokers, ex-smokers, and nonsmokers). For cycle 4 and cycle 5 (after dust control), there was a reduction in the prevalence of these respiratory symptoms. For example, in cycle 1, the prevalence of chronic wheeze among current smoking grain workers increased from 12% (for those in the industry for 35 years); in cycle 5, the prevalence of chronic wheeze among current smoking grain workers increased from 9% (for those in the industry for 35 years). Similar trends were observed for ex-smokers and nonsmokers and for other chronic respiratory symptoms. Our results indicate that grain dust control was effective in reducing the prevalence of chronic respiratory symptoms among grain workers in all smoking and exposure categories.

  12. Associations between respiratory symptoms, lung function and gastro-oesophageal reflux symptoms in a population-based birth cohort

    Herbison G Peter

    2006-12-01

    Full Text Available Abstract Background Several studies have reported an association between asthma and gastro-oesophageal reflux, but it is unclear which condition develops first. The role of obesity in mediating this association is also unclear. We explored the associations between respiratory symptoms, lung function, and gastro-oesophageal reflux symptoms in a birth cohort of approximately 1000 individuals. Methods Information on respiratory symptoms, asthma, atopy, lung function and airway responsiveness was obtained at multiple assessments from childhood to adulthood in an unselected birth cohort of 1037 individuals followed to age 26. Symptoms of gastro-oesophageal reflux and irritable bowel syndrome were recorded at age 26. Results Heartburn and acid regurgitation symptoms that were at least "moderately bothersome" at age 26 were significantly associated with asthma (odds ratio = 3.2; 95% confidence interval = 1.6–6.4, wheeze (OR = 3.5; 95% CI = 1.7–7.2, and nocturnal cough (OR = 4.3; 95% CI = 2.1–8.7 independently of body mass index. In women reflux symptoms were also associated with airflow obstruction and a bronchodilator response to salbutamol. Persistent wheezing since childhood, persistence of asthma since teenage years, and airway hyperresponsiveness since age 11 were associated with a significantly increased risk of heartburn and acid regurgitation at age 26. There was no association between irritable bowel syndrome and respiratory symptoms. Conclusion Reflux symptoms are associated with respiratory symptoms in young adults independently of body mass index. The mechanism of these associations remains unclear.

  13. Cough: neurophysiology, methods of research, pharmacological therapy and phonoaudiology

    Balbani, Aracy Pereira Silveira

    2012-01-01

    Full Text Available Introduction: The cough is the more common respiratory symptom in children and adults. Objective: To present a revision on the neurophysiology and the methods for study of the consequence of the cough, as well as the pharmacotherapy and phonoaudiology therapy of the cough, based on the works published between 2005 and 2010 and indexed in the bases Medline, Lilacs and Library Cochrane under them to keywords "cough" or "anti-cough". Synthesis of the data: The consequence of the cough involves activation of receiving multiples becomes vacant in the aerial ways and of neural projections of the nucleus of the solitary treatment for other structures of the central nervous system. Experimental techniques allow studying the consequence of the cough to the cellular and molecular level to develop new anti-cough agents. It does not have evidences of that anti-cough exempt of medical lapsing they have superior effectiveness to the one of placebo for the relief of the cough. The phonoaudiology therapy can benefit patients with refractory chronic cough to the pharmacological treatment, over all when paradoxical movement of the vocal folds coexists. Final Comments: The boarding to multidiscipline has basic paper in the etiological diagnosis and treatment of the cough. The otolaryngologist must inform the patients on the risks of the anti-cough of free sales in order to prevent adverse poisonings and effect, especially in children.

  14. Whooping Cough (Pertussis)

    ... Staying Safe Videos for Educators Search English Español Whooping Cough (Pertussis) KidsHealth / For Parents / Whooping Cough (Pertussis) What's in this article? Signs & Symptoms Contagiousness ...

  15. Recognizing and Preventing Whooping Cough

    2015-01-22

    This podcast provides information about the symptoms of whooping cough and how vaccines can help prevent this serious disease for people of all ages. It is especially important for those who will have close contact with a baby to be up to date with their whooping cough vaccine.  Created: 1/22/2015 by National Center for Immunization and Respiratory Diseases (NCIRD), Division of Bacterial Diseases (DBD), Meningitis and Vaccine Preventable Diseases Branch (MVPDB).   Date Released: 1/22/2015.

  16. Prenatal ambient air exposure to polycyclic aromatic hydrocarbons and the occurrence of respiratory symptoms over the first year of life.

    Jedrychowski, Wieslaw; Galas, Aleksander; Pac, Agnieszka; Flak, Elzbieta; Camman, David; Rauh, Virginia; Perera, Frederica

    2005-01-01

    The purpose of the study was to test the hypothesis that infants with higher levels of prenatal exposure to polycyclic aromatic hydrocarbons (PAHs) from fossil fuel combustion may be at greater risk of developing respiratory symptoms. The study was carried out in a cohort of 333 newborns in Krakow, Poland, followed over the first year of life, for whom data from prenatal personal air monitoring of mothers in the second trimester of pregnancy were available. The relative risks of respiratory symptoms due to prenatal PAHs exposure were adjusted for potential confounders (gender of child, birth weight, maternal atopy, maternal education as a proxy for the socio-economic status, exposure to postnatal environmental tobacco smoke, and moulds in households) in the Poisson regression models. Increased risk related to prenatal PAH exposure was observed for various respiratory symptoms such as barking cough (RR = 4.80; 95% CI: 2.73-8.44), wheezing without cold (RR = 3.83; 95% CI: 1.18-12.43), sore throat (RR = 1.96; 95% CI: 1.38-2.78), ear infection (RR = 1.82; 95% CI: 1.03-3.23), cough irrespective of respiratory infections (RR=1.27; 95% CI: 1.07-1.52), and cough without cold (RR = 1.72; 95% CI: 1.02-2.92). The exposure to PAHs also had impact on the duration of respiratory symptoms. The effect of PAHs exposure on the occurrence of such symptoms as runny nose or cough was partly modified by the simultaneous exposure to postnatal passive smoking. The analysis performed for the duration of respiratory symptoms confirmed significant interaction between PAHs exposure and postnatal ETS for runny or stuffy nose (RR = 1.82; 95% CI: 1.57-2.10), cough (RR = 1.18; 95% CI: 0.99-1.40), difficulty in breathing (RR = 1.39; 95% CI: 1.01-1.92) and sore throat (RR = 1.74; 1.26-2.39). Obtained results support the hypothesis that prenatal exposure to immunotoxic PAHs may impair the immune function of the fetus and subsequently may be responsible for an increased susceptibility of newborns and

  17. An annoying persistent cough

    Francesco Cipollini

    2007-03-01

    Full Text Available Chronic cough is a stressful condition and can lead to extensive investigations. We report a case of a 48-year-old woman who had suffered from persistent chronic cough for more than 3 months. She had been treated with cough suppressant. However, her cough was not alleviated by these treatments, and the patient was referred to our hospital. She did not exhibit typical gastroesophageal reflux disease (GERD symptoms heartburn and regurgitation. Esophagoscopy did not disclose reflux esophagitis. The patient was treated with a proton-pump inhibitor, which markedly alleviated her cough. Chronic cough due to GERD was diagnosed. Although the diagnosis of chronic cough due to GERD is not easy when traditionally symptoms are not present, our case report underscores the importance of this association to the differential diagnosis of chronic cough. In these cases a relatively simple test as high dose proton pump-inhibitors trial may be useful to confirm GERD related cough.

  18. Could patients' coughing have communicative significance?

    Bailey, Julia V

    2008-01-01

    Medical discourse positions patients with coughs and colds negatively, so consulting health services with 'minor' respiratory illness is therefore more accountable than for other medical problems. Patients face dilemmas since they must persuade doctors of the doctorability of their illness without being seen as hypochondriacal, and they risk losing face if doctors decide that there is nothing much wrong. It is known that the placement of non-lexical features of talk such as laughing or crying can have interactional meaning. Using a data set of video-recorded doctor-patient cough and cold consultations, this study explores whether patients' coughing could have communicative significance. The study is a qualitative analysis of 33 consultations drawing on a constructionist, sociolinguistic analytic approach. Coughing is co-ordinated with talk rather than occurring randomly. Coughing helps patients to demonstrate the doctorability of their symptoms and to legitimize their claims for medical attention. Coughing is also associated with resistance to 'no problem' diagnoses, resulting in changes in the trajectory of talk (for example, soliciting more explanation from doctors and/or re-negotiation of doctors' investigation or treatment plans). Coughing is undoubtedly a manifestation of respiratory illness, but also has communicative significance in consultations for coughs and colds.

  19. Respiratory rate greater than 50 per minute as a clinical indicator of pneumonia in Filipino children with cough.

    Lucero, M G; Tupasi, T E; Gomez, M L; Beltran, G L; Crisostomo, A U; Romano, V V; Rivera, L M

    1990-01-01

    The diagnosis and epidemiology of acute respiratory tract infection (ARI) in 199 children less than 5 years old were investigated in Manila. As part of this study, children who were treated at one of two outpatient clinics for cough of less than 3 weeks' duration were studied to test the validity of the use of a respiratory rate (RR) of greater than 50/minute for identifying ARI of a severity necessitating treatment with antibiotics. In the first population, in which 69% of the children had radiologically confirmed pneumonia, the sensitivity of a RR of greater than 50/minute was 54%, the specificity was 84%, the false-positive rate was 16%, and the false-negative rate was 46%. In the second population, in which 29% of the children had pneumonia, the sensitivity and positive predictive values were low. The validity of a RR of greater than 50/minute may vary in populations with different prevalences of ARI.

  20. Lifestyle factors and experience of respiratory alarm symptoms in the general population

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

    2015-01-01

    BACKGROUND: The first step in the diagnosis of lung cancer is for individuals in the general population to recognise respiratory alarm symptoms (RAS). Knowledge is sparse about RAS and factors associated with experiencing RAS in the general population. This study aimed to estimate the prevalence...... of RAS in the general population, and to analyse possible associations between lifestyle factors and experiencing RAS. METHODS: A web-based survey comprising 100 000 individuals randomly selected from the Danish Civil Registration System. Items regarding experience of RAS (prolonged coughing, shortness...

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

    Paknejad O

    2011-02-01

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

  2. [Respiratory symptoms and obstructive ventilatory disorder in Tunisian woman exposed to biomass].

    Kwas, H; Rahmouni, N; Zendah, I; Ghédira, H

    2017-06-01

    In some Tunisian cities, especially semi-urbanized, the exposure to the smoke produced during combustion of the biomass, main source of pollution of indoor air, remains prevalent among non-smoking women. To assess the relationship between exposure to biomass smoke and the presence of obstructive ventilatory disorder in the non-smoking women in semi-urban areas of Tunisia. Cross etiological study, using a questionnaire, including 140 non-smoking women responsible for cooking and/or exposed during heating by traditional means with objective measurement of their respiratory functions. We found 81 women exposed to biomass for a period > or equal to 20 hours-years and 59 unexposed women. Exposed women reported more respiratory symptoms namely exertional dyspnea and/or chronic cough than unexposed. Of the 140 women, 14 women have an FEV/FEV6 biomass. We found a correlation between respiratory symptoms and obstructive ventilatory disorder in exposed women. The air pollution inside the home during the traditional activities of cooking and/or heating is a respiratory risk factor for non-smoking women over the age of 30 years. Exposure to biomass smoke can cause chronic respiratory symptoms and persistent obstructive ventilatory disorder that can be consistent with COPD. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  3. Prevalence of respiratory symptoms and disorders among rice mill workers in India.

    Ghosh, Tirthankar; Gangopadhyay, Somnath; Das, Banibrata

    2014-05-01

    Lung function tests have become an integral part of assessment of pulmonary disease. Diseases of the respiratory system induced by occupational dusts are influenced by the duration of exposure. The aim of the study is to investigate the impairment of lung function and prevalence of respiratory symptoms among the rice mill workers. A total of 120 rice mill workers from three districts of Karnataka were included in this study. Fifty urban dwellers from the same socio-economic level were selected as controls. The study included clinical examination, assessment of respiratory symptoms, pulmonary function test, measurement of peak expiratory flow rate, absolute eosinophil count, ESR estimation, total IgE estimation and radiographic test. The present study has shown that the rice mill workers complained of several types of respiratory disorders like phlegm (40.8 %), dyspnea (44.2 %), chest tightness (26.7 %), cough (21.7 %), and nose irritation (27.5 %). Rice mill workers exposed to dust presented significantly (p workers are having significantly higher absolute eosinophil counts, total IgE and ESR than control groups. The hematological findings suggest that the harmful effects may be linked to both non-specific irritation and allergic responses to rice husk dust among rice mill workers. Dust exposure in the working environment affects the lung function values and increased the respiratory symptoms among the rice mill workers.

  4. The Differential Impact of Emphysema on Respiratory Symptoms and 6-Minute Walk Distance in HIV Infection.

    Triplette, Matthew; Attia, Engi; Akgün, Kathleen; Campo, Monica; Rodriguez-Barradas, Maria; Pipavath, Sudhakar; Shahrir, Shahida; Wongtrakool, Cherry; Goetz, Matthew; Kim, Joon; Soo Hoo, Guy W; Brown, Sheldon T; Crothers, Kristina

    2017-01-01

    Emphysema is more prevalent in HIV-infected (HIV+) patients independent of smoking behavior. Nonetheless, health effects of emphysema in this population are poorly understood. We determined whether emphysema is associated with a greater burden of pulmonary symptoms and a lower 6-minute walk distance (6MWD) in HIV+ compared with HIV-uninfected (HIV-) subjects. We performed a cross-sectional analysis of 170 HIV+ and 153 HIV- subjects in the Examinations of HIV-Associated Lung Emphysema (EXHALE) cohort study. Subjects completed a self-assessment of respiratory symptoms, pulmonary function testing, and 6MWD testing as well as a chest computed tomography to determine emphysema severity. We used regression models to determine the association of emphysema with respiratory symptoms and 6MWD in HIV+ subjects and compared this to HIV- subjects. Models stratified by HIV status demonstrated an association between >10% radiographic emphysema and chronic cough and/or phlegm and 6MWD in HIV+ subjects. These associations persisted among the subset without airflow obstruction: those with emphysema had 4.2 (95% confidence interval: 1.3 to 14) times the odds of chronic cough and/or phlegm and walked 60 m (95% confidence interval: 26 to 93) less distance than those without emphysema. There was no association between >10% emphysema and symptoms or 6MWD in HIV- subjects. In our cohort, >10% radiographic emphysema was associated with chronic cough and/or phlegm and lower 6MWD in HIV+ but not HIV- subjects. These findings were robust even among HIV+ subjects with milder forms of emphysema and those without airflow obstruction, highlighting the clinical impact of emphysema in these patients.

  5. Respiratory symptoms and ventilatory performance in workers exposed to grain and grain based food dusts.

    Deacon, S P; Paddle, G M

    1998-05-01

    A health surveillance study of male grain food manufacturing workers used a respiratory health questionnaire and spirometry to assess the prevalence of work-related respiratory symptoms and impaired ventilatory performance. The prevalence of cough, breathlessness, wheeze and chest tightness was between 8-13% but was 20% for rhinitis. Rhinitis was the most common symptom with 37% of those reporting rhinitis describing this as work-related. A case-control analysis of workers reporting rhinitis did not identify any specific occupational activities associated with increased risk of rhinitis. Smoking habit and all respiratory symptoms apart from rhinitis had a significant effect upon ventilatory performance. Occupational exposure to raw grains, flour, ingredients and finished food was categorized as high, medium or low in either continuous or intermediate patterns. Multiple regression analysis confirmed the effects of height, age and smoking upon ventilatory performance. However, occupational exposure to grain, flour, food ingredients and cooked food dusts had no effect upon ventilatory performance. It is concluded that smoking habit is the major determinant of respiratory symptoms and impaired ventilatory function. The excess complaints of rhinitis warrant further study but it would appear that the current occupational exposure limits for grain, flour, food ingredients and cooked food dusts are adequate to protect workers against impairment of ventilatory performance.

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

    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

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

    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.

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

    2009-02-06

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

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

    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

  10. Cough and environmental air pollution in China.

    Zhang, Qingling; Qiu, Minzhi; Lai, Kefang; Zhong, Nanshan

    2015-12-01

    With fast-paced urbanization and increased energy consumption in rapidly industrialized modern China, the level of outdoor and indoor air pollution resulting from industrial and motor vehicle emissions has been increasing at an accelerated rate. Thus, there is a significant increase in the prevalence of respiratory symptoms such as coughing, wheezing, and decreased pulmonary function. Experimental exposure research and epidemiological studies have indicated that exposure to particulate matter, ozone, nitrogen dioxide, and environmental tobacco smoke have a harmful influence on development of respiratory diseases and are significantly associated with cough and wheeze. This review mainly discusses the effect of air pollutants on respiratory health, particularly with respect to cough, the links between air pollutants and microorganisms, and air pollutant sources. Particular attention is paid to studies in urban areas of China where the levels of ambient and indoor air pollution are significantly higher than World Health Organization recommendations. Copyright © 2015 Elsevier Ltd. All rights reserved.

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

    Mehta Shruti H

    2010-05-01

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

  12. A twin study of perfume-related respiratory symptoms

    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...

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

    Sakwari, Gloria; Bråtveit, Magne; Mamuya, Simon H D; Moen, Bente E

    2011-11-24

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

  14. Respiratory symptoms in people living with HIV and the effect of antiretroviral therapy: a systematic review and meta-analysis.

    Brown, James; Roy, Anjana; Harris, Ross; Filson, Sarah; Johnson, Margaret; Abubakar, Ibrahim; Lipman, Marc

    2017-04-01

    Antiretroviral therapy (ART) has significantly altered the pattern of acute and chronic HIV-related disease. However, it is not clear what this means in terms of respiratory symptoms. We sought to investigate the association between HIV status and respiratory symptoms and how these have changed with the availability of ART. We searched Cochrane, Medline and Embase databases for studies published between 1946 and August 2015 comparing the prevalence of respiratory symptoms in populations with and without HIV infection. We undertook random effects meta-analysis of the main symptoms reported. We studied heterogeneity and completed sensitivity analyses and funnel plots. From 5788 unique references identified, 24 papers provided relevant data: 18 documented the prevalence of cough and 11 examined the prevalence of breathlessness among other symptoms reported. Compared with the HIV negative, people living with HIV (PLWH) were more likely to have respiratory symptoms with pooled ORs for the prevalence of cough of 3.05 (95% CI 2.24 to 4.16) in resource-limited populations without access to ART; 2.18 (1.56 to 3.18) in resource-rich populations without access to ART and 1.11 (0.99 to 1.24) in resource-rich populations with access to ART. In resource-rich settings, although the availability of ART was associated with a reduction in the difference between HIV-positive and HIV-negative individuals, PLWH were more likely to report breathlessness, OR 1.39 (95% CI 1.11 to 1.73). Respiratory symptoms are more common in PLWH than controls. This association persists although at a reduced level in populations with access to ART. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  15. A new paradigm in respiratory hygiene: modulating respiratory secretions to contain cough bioaerosol without affecting mucus clearance

    Bonilla Gloria

    2007-08-01

    Full Text Available Abstract Background Several strategies and devices have been designed to protect health care providers from acquiring transmissible respiratory diseases while providing care. In modulating the physical characteristics of the respiratory secretions to minimize the aerosolization that facilitates transmission of airborne diseases, a fundamental premise is that the prototype drugs have no adverse effect on the first line of respiratory defense, clearance of mucus by ciliary action. Methods To assess and demonstrate the primary mechanism of our mucomodulators (XLs, we have built our evidence moving from basic laboratory studies to an ex-vivo model and then to an in-vivo large animal model. We exposed anesthetized dogs without hypersecretion to different dose concentrations of aerosolized XL "B", XL "D" and XL "S". We assessed: cardio-respiratory pattern, tracheal mucus clearance, airway patency, and mucus viscoelastic changes. Results Exposure of frog palate mucus to XLs did not affect the clearance of mucus by ciliary action. Dogs maintained normal cardio-respiratory pattern with XL administration. Tracheal mucociliary clearance in anesthetized dogs indicated a sustained 40% mean increase. Tracheal mucus showed increased filance, and there was no mucus retention in the airways. Conclusion The ex-vivo frog palate and the in-vivo mammalian models used in this study, appear to be appropriate and complement each other to better assess the effects that our mucomodulators exert on the mucociliary clearance defence mechanism. The physiological function of the mucociliary apparatus was not negatively affected in any of the two epithelial models. Airway mucus crosslinked by mucomodulators is better cleared from an intact airway and normally functioning respiratory system, either due to enhanced interaction with cilia or airflow-dependent mechanisms. Data obtained in this study allow us to assure that we have complied with the fundamental requirement

  16. Psychological profile of individuals presenting with chronic cough

    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.

  17. Smoking duration, respiratory symptoms, and COPD in adults aged ≥45 years with a smoking history

    Liu, Yong; Pleasants, Roy A; Croft, Janet B; Wheaton, Anne G; Heidari, Khosrow; Malarcher, Ann M; Ohar, Jill A; Kraft, Monica; Mannino, David M; Strange, Charlie

    2015-01-01

    Background The purpose of this study was to assess the relationship of smoking duration with respiratory symptoms and history of chronic obstructive pulmonary disease (COPD) in the South Carolina Behavioral Risk Factor Surveillance System survey in 2012. Methods Data from 4,135 adults aged ≥45 years with a smoking history were analyzed using multivariable logistic regression that accounted for sex, age, race/ethnicity, education, and current smoking status, as well as the complex sampling design. Results The distribution of smoking duration ranged from 19.2% (1–9 years) to 36.2% (≥30 years). Among 1,454 respondents who had smoked for ≥30 years, 58.3% were current smokers, 25.0% had frequent productive cough, 11.2% had frequent shortness of breath, 16.7% strongly agreed that shortness of breath affected physical activity, and 25.6% had been diagnosed with COPD. Prevalence of COPD and each respiratory symptom was lower among former smokers who quit ≥10 years earlier compared with current smokers. Smoking duration had a linear relationship with COPD (Psmoking status and other covariates. While COPD prevalence increased with prolonged smoking duration in both men and women, women had a higher age-adjusted prevalence of COPD in the 1–9 years, 20–29 years, and ≥30 years duration periods. Conclusion These state population data confirm that prolonged tobacco use is associated with respiratory symptoms and COPD after controlling for current smoking behavior. PMID:26229460

  18. Management of respiratory symptoms in ALS.

    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.

  19. Management of respiratory symptoms in ALS.

    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.

  20. Respiratory symptoms in workers at Katako wood market, Jos ...

    ... dust toxic syndrome, occupational asthma, airway inflammation, an increased risk ... This study determines the prevalence of respiratory symptoms and the lung ... Only one (0.8%) of the workers had peak expiratory flow volume (PEFV) less ...

  1. Elevated exhaled nitric oxide in anaphylaxis with respiratory symptoms

    Yoichi Nakamura

    2015-10-01

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

  2. First Aid: Coughing

    ... this topic for: Parents Kids Teens Flu Center Asthma Center Your Child's Immunizations: Diphtheria, Tetanus & Pertussis Vaccine (DTaP) Whooping Cough (Pertussis) Is It a Cold or the Flu? Why Is Hand Washing So ... Asthma Center Flu Center Whooping Cough Your Lungs & Respiratory ...

  3. Influence of smoking on respiratory symptoms and lung function ...

    The study was done to assess the influence of smoking on respiratory symptoms and respiratory function in sawmill workers in Benin City. 150 sawmill workers who were all males and aged between 18 and 50 years, and had been in continuous employment in sawmill factories for a minimum of one year were studied.

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

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

    2015-04-02

    In the cotton industry of Pakistan, 15 million people are employed and exposed to cotton dust, toxic chemicals, noise and physical hazards. The aim of this study was to determine the prevalence of health symptoms, particularly respiratory symptoms, and to measure cotton dust and endotoxin levels in different textile factories of Faisalabad, Pakistan. A cross-sectional investigation was performed in a representative sample of 47 cotton factories in the Faisalabad region in Punjab, Pakistan. Respiratory symptoms of 800 workers were documented by questionnaire. Occupational safety in the factories was assessed by a trained expert following a checklist, and dust and endotoxin levels in different work areas were measured. Prevalence of respiratory disease symptoms (fever, shortness of breath, chest tightness and cough) was generally high and highest in the weaving section of the cotton industry (20-40% depending on symptoms). This section also displayed the poorest occupational safety ratings and the highest levels of inhalable cotton dust (mean±SD 4.6±2.5 vs 0.95±0.65 mg/m(3) in compact units). In contrast, endotoxin levels were highest in the spinning section (median 1521 EU/m(3)), where high humidity is maintained. There are still poor working conditions in the cotton industry in Pakistan where workers are exposed to different occupational hazards. More health symptoms were reported from small weaving factories (power looms). There is a dire need for improvements in occupational health and safety in this industrial sector with particular focus on power looms. 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.

  5. Respiratory symptoms and lung function in bauxite miners.

    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.

  6. Fine Particulate Matter in Urban Environments: A Trigger of Respiratory Symptoms in Sensitive Children

    Daniel Dunea

    2016-12-01

    Full Text Available The overall objective of this research was to study children’s respiratory illness levels in Targoviste (Romania in relationship to the outdoor concentrations of airborne particulate matter with an aerodynamic diameter below 2.5 µm (PM2.5. We monitored and analysed the PM2.5 concentrations according to a complex experimental protocol. The health trial was conducted over three months (October–December 2015 and required the active cooperation of the children’s parents to monitor carefully the respiratory symptoms of the child, i.e., coughing, rhinorrhoea, wheezing, and fever, as well as their outdoor program. We selected the most sensitive children (n = 25; age: 2–10 years with perturbed respiratory health, i.e., wheezing, asthma, and associated symptoms. The estimated average PM2.5 doses were 0.8–14.5 µg·day−1 for weekdays, and 0.4–6.6 µg·day−1 for the weekend. The frequency and duration of the symptoms decreased with increasing age. The 4- to 5-year old children recorded the longest duration of symptoms, except for rhinorrhoea, which suggested that this age interval is the most vulnerable to exogenous trigger agents (p < 0.01 compared to the other age groups. PM2.5 air pollution was found to have a direct positive correlation with the number of wheezing episodes (r = 0.87; p < 0.01 in November 2015. Monitoring of wheezing occurrences in the absence of fever can provide a reliable assessment of the air pollution effect on the exacerbation of asthma and respiratory disorders in sensitive children.

  7. Respiratory symptoms and ventilatory function impairment among ...

    Both upper and lower respiratory tract diseaes have been noticed and described. Several publications are found in the literature on these but no such report has come from the Savannah belt with its peculiar climatic conditions. Methods: One hundred and forty (140) workers in a wood furniture factory in Kaduna, a city within ...

  8. Airborne chemicals cause respiratory symptoms in individuals with contact allergy

    Elberling, J; Linneberg, A; Mosbech, H

    2005-01-01

    Exposure to fragrance chemicals causes various eye and airway symptoms. Individuals with perfume contact allergy report these symptoms more frequently than individuals with nickel allergy or no contact allergies. However, the associations between contact allergy and respiratory symptoms elicited...... by airborne chemicals other than perfumes are unclear. The study aimed to investigate the association between eye and airway symptoms elicited by airborne chemicals (other than perfumes) and contact allergy in a population-based sample. A questionnaire on respiratory symptoms was posted, in 2002, to 1189...... individuals who participated in 1997/1998 in a Danish population-based study of allergic diseases. Questions about eye and airway symptoms elicited by different airborne chemicals and airborne proteins were included in the questionnaire. Data from the questionnaire were compared with data on patch testing...

  9. Gender differences in respiratory symptoms-does occupation matter?

    Dimich-Ward, Helen; Camp, Patricia G; Kennedy, Susan M

    2006-06-01

    Little attention has been given to gender differences in respiratory health, particularly in occupational settings. The purpose of this paper was to evaluate gender differences in respiratory morbidity based on surveys of hospitality workers, radiographers, and respiratory therapists. Data were available from mail surveys of 850 hospitality industry workers (participation rate 73.9%; 52.6% female), 586 radiographers (participation rate 63.6%; 85% female), and 275 respiratory therapists (participation rate 64.1%; 58.6% female). Cross-tabulations by gender were evaluated by chi(2) analysis and logistic regression with adjustment for personal and work characteristics. Women consistently had greater respiratory morbidity for symptoms associated with shortness of breath, whereas men usually had a higher prevalence of phlegm. There were few differences in work exposures apart from perception of exposure to ETS among hospitality workers. Gender differences in symptoms were often reduced after adjustment for personal and work characteristics but for respiratory therapists there were even greater gender disparities for asthma attack and breathing trouble. Population health findings of elevated symptoms among women were only partially supported by these occupational respiratory health surveys. The influence of differential exposures and personal factors should be considered when interpreting gender differences in health outcomes.

  10. Gender differences in respiratory symptoms-Does occupation matter?

    Dimich-Ward, Helen; Camp, Patricia G.; Kennedy, Susan M.

    2006-01-01

    Little attention has been given to gender differences in respiratory health, particularly in occupational settings. The purpose of this paper was to evaluate gender differences in respiratory morbidity based on surveys of hospitality workers, radiographers, and respiratory therapists. Data were available from mail surveys of 850 hospitality industry workers (participation rate 73.9%; 52.6% female), 586 radiographers (participation rate 63.6%; 85% female), and 275 respiratory therapists (participation rate 64.1%; 58.6% female). Cross-tabulations by gender were evaluated by χ 2 analysis and logistic regression with adjustment for personal and work characteristics. Women consistently had greater respiratory morbidity for symptoms associated with shortness of breath, whereas men usually had a higher prevalence of phlegm. There were few differences in work exposures apart from perception of exposure to ETS among hospitality workers. Gender differences in symptoms were often reduced after adjustment for personal and work characteristics but for respiratory therapists there were even greater gender disparities for asthma attack and breathing trouble. Population health findings of elevated symptoms among women were only partially supported by these occupational respiratory health surveys. The influence of differential exposures and personal factors should be considered when interpreting gender differences in health outcomes

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

    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.

  12. Decreased respiratory symptoms in cannabis users who vaporize

    Barnwell Sara

    2007-04-01

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

  13. Characteristics of Chinese patients with cough in primary care centre

    Bai Chunxue

    2011-09-01

    Full Text Available Abstract Background Cough is one of the most common respiratory symptoms and is well characterized in specialized cough clinics with high success rates of diagnosis and treatment. However, there is a paucity of data regarding cough in primary care settings. The present study aimed at investigating clinical epidemiology of cough through a national study of two questionnaire surveys sent to primary care physicians in China. Methods Approximately 18,000 subjects recruited were having daytime or night symptoms of cough and diagnoses of respiratory disease from February 2005 to April 2006 as Survey 1 and from June 2007 to December 2007 as Survey 2. Patients suffering from respiratory malignancy, hyperthyroidism, hypertension, heart disease, diabetes, severe hypohepatia or renal dysfunction, pregnancy, possible pregnancy or lactation, neutropenia were not eligible. Information regarding demography, history of allergies, symptomatic profile, treatment and curative effects for cough was elicited. Results 8216 questionnaires were collected in Survey 1 and 9711 in Survey 2. The mean values of ages were 25.7 and 22.3 years old, respectively. Symptoms included expectoration (74% and 76%, wheeze (59% and 74%, breathlessness (22% and 26%, chest pain (9% and 13% and fever (15% and 18%. About 15% and 23% patients had hypersusceptibility, of whom 6% to 17% had a family history. More than 50% of the cases had histories of allergic rhinitis, asthma, conjunctivitis or atopic dermatitis. Asthma, COPD, and bronchitis were dominant etiologies of cough. Procaterol or the combination of antibiotics and steroids were used as the treatment. Conclusion Causes and outcomes of cough differed with ages and time in this particular national study, while successful and precise diagnosis and management of cough in primary care settings need to be further improved in China.

  14. Heavy metals in PM_2_._5 and in blood, and children's respiratory symptoms and asthma from an e-waste recycling area

    Zeng, Xiang; Xu, Xijin; Zheng, Xiangbin; Reponen, Tiina; Chen, Aimin; Huo, Xia

    2016-01-01

    This study was to investigate the levels of heavy metals in PM_2_._5 and in blood, the prevalence of respiratory symptoms and asthma, and the related factors to them. Lead and cadmium in both PM_2_._5 and blood were significant higher in Guiyu (exposed area) than Haojiang (reference area) (p  5 μg/dL was significantly associated with asthma (OR, 9.50; 95% CI, 1.16–77.49). Higher blood chromium and blood manganese were associated with more cough and wheeze, respectively. Our data suggest that living in e-waste exposed area may lead to increased levels of heavy metals, and accelerated prevalence of respiratory symptoms and asthma. - Highlights: • Higher levels of Pb and Cd pollution are found in PM_2_._5 and in blood from Guiyu. • Higher prevalence of respiratory symptoms is observed in children from Guiyu. • Living in Guiyu is associated with increased levels of Pb and Cd. • Living in Guiyu may lead to elevated prevalence of respiratory symptoms. • High prevalence of cough and phlegm in Guiyu comes from contacting with e-waste. - Heavy metal levels in PM_2_._5 and in blood, and the association between living area and heavy metals, respiratory symptoms and asthma.

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

    Bożena Krogulska

    2013-02-01

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

  16. Cough in idiopathic pulmonary fibrosis

    Mirjam J.G. van Manen

    2016-09-01

    Full Text Available Many patients with idiopathic pulmonary fibrosis (IPF complain of chronic refractory cough. Chronic cough is a distressing and disabling symptom with a major impact on quality of life. During recent years, progress has been made in gaining insight into the pathogenesis of cough in IPF, which is most probably “multifactorial” and influenced by mechanical, biochemical and neurosensory changes, with an important role for comorbidities as well. Clinical trials of cough treatment in IPF are emerging, and cough is increasingly included as a secondary end-point in trials assessing new compounds for IPF. It is important that such studies include adequate end-points to assess cough both objectively and subjectively. This article summarises the latest insights into chronic cough in IPF. It describes the different theories regarding the pathophysiology of cough, reviews the different methods to assess cough and deals with recent and future developments in the treatment of cough in IPF.

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

    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

  18. Asthma and respiratory symptoms among hairdressers in Denmark

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

    2014-01-01

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

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

    Wan C Tan

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

  20. Decline in air pollution and change in prevalence in respiratory symptoms and chronic obstructive pulmonary disease in elderly women.

    Schikowski, Tamara; Ranft, Ulrich; Sugiri, Dorothee; Vierkötter, Andrea; Brüning, Thomas; Harth, Volker; Krämer, Ursula

    2010-08-22

    While adverse effects of exposure to air pollutants on respiratory health are well studied, little is known about the effect of a reduction in air pollutants on chronic respiratory symptoms and diseases. We investigated whether different declines in air pollution levels in industrialised and rural areas in Germany were associated with changes in respiratory health over a period of about 20 years. We used data from the SALIA cohort study in Germany (Study on the influence of Air pollution on Lung function, Inflammation and Aging) to assess the association between the prevalence of chronic obstructive pulmonary disease (COPD) and chronic respiratory symptoms and the decline in air pollution exposure. In 1985-1994, 4874 women aged 55-years took part in the baseline investigation. Of these, 2116 participated in a questionnaire follow-up in 2006 and in a subgroup of 402 women lung function was tested in 2008-2009. Generalized estimating equation (GEE) models were used to estimate the effect of a reduction in air pollution on respiratory symptoms and diseases. Ambient air concentrations of particulate matter with aerodynamic size respiratory symptoms and COPD. Among women who never smoked, the prevalence of chronic cough with phlegm and mild COPD was estimated at 21.4% and 39.5%, respectively, if no air pollution reduction was assumed, and at 13.3% and 17.5%, respectively, if air pollution reduction was assumed. We concluded that parallel to the decline of ambient air pollution over the last 20 years in the Ruhr area the age-related increase in chronic respiratory diseases and symptoms appears to attenuate in the population of elderly women.

  1. Nonprescription medications for respiratory symptoms: Facts and marketing fictions.

    Weinberger, Miles; Hendeles, Leslie

    2018-05-01

    There are many nonprescription (over-the-counter [OTC]) medications available on pharmacy shelves marketed for relief of respiratory symptoms. The number of such medications has been increasing. This review provides an evidence-based examination of OTC products used for respiratory symptoms. Antihistamines, decongestants, mucolytics, antitussives, and intranasal steroids were selected as the most common OTC medications taken by adults and children for various respiratory symptoms. Controlled clinical trials of efficacy were identified by searching a medical literature data base. Those trials and key publications related to the pharmacokinetics and pharmacodynamics of the products were reviewed. Comparisons of the various OTC antihistamines' ability to suppress the effects of histamine were related to their clinical benefit. Intranasal corticosteroids are the preferred agents for maintenance therapy of persistent nasal congestion and are highly effective for symptoms of inhalant allergy other than allergic conjunctivitis. The disconnect between marketing claims and evidence was demonstrated for antihistamines and oral alpha-1 adrenergic agonist decongestants. Data for OTC mucolytics and antitussives were insufficient to justify their use based on the evidence. There was little relationship between marketing claims and evidence regarding OTC medications used for respiratory symptoms. Analysis of data supported cetirizine, levocetirizine, and fexofenadine as the most effective of the OTC antihistamines. There were no data that supported the use of oral phenylephrine as a decongestant. Neither OTC mucolytics or antitussives provided sufficient evidence to justify their use.

  2. Malignant peritoneal mesothelioma presenting with respiratory symptoms

    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.)

  3. The case study about Polymyositis patient with respiratory symptoms

    Ki-su Lee

    2010-06-01

    Full Text Available Objective : This is a clinical report about the 77-years-old man patient with polymyositis treated by oriental medicine. Methods : The paitent was treated by acupuncture and herb medication. The improvement of the patient was judged by MRC scale and CPK, LDH. Results & Conclusions : 1. Patient's symptoms(paraplegia rapidly improved. 2. The level of CPK, LDH and Potassium are recovered to the normal range. 3. Associated with respiratory symptoms are getting better.

  4. Consultation expectations among patients with respiratory tract infection symptoms

    Lauridsen, Gitte Bruun; Sørensen, Mette Sejr; Hansen, Malene Plejdrup

    2017-01-01

    INTRODUCTION: Antibiotic resistance is a growing threat to public health, and antibiotic prescribing increases. About 90% of antibiotics are prescribed in general practice, mostly for acute respiratory tract infections. It is well known that patient expectations and general practitioners......' misinterpretation of patients' expectations are associated with antibiotic overuse. The aim of this study was to explore Danish patients' expectations when consulting a general practitioner with symptoms of acute respiratory tract infection, and to determine predictors for these expectations. METHODS......: A questionnaire survey was conducted in Danish primary care during 2014. Patients aged ≥ 18 years were asked about their expectations to the consultation when consulting with symptoms of acute respiratory tract infections. Associations between socio-demographic characteristics, self-reported antibiotic...

  5. Consultation expectations among patients with respiratory tract infection symptoms

    Bruun Lauridsen, Gitte; Sejr Sørensen, Mette; Hansen, Malene Plejdrup

    2017-01-01

    Introduction: Antibiotic resistance is a growing threat to public health, and antibiotic prescribing increases. About 90% of antibiotics are prescribed in general practice, mostly for acute respiratory tract infections. It is well known that patient expectations and general practitioners’ misinter......­pretation of patients’ expectations are associated with antibiotic overuse. The aim of this study was to explore Danish patients’ expectations when consulting a general prac­titioner with symptoms of acute respiratory tract infection, and to determine predictors for these expectations. Methods: A questionnaire survey...... was conducted in Danish primary care during 2014. Patients aged ≥ 18 years were asked about their expectations to the consultation when consulting with symptoms of acute respiratory tract infections. Associations between socio-demographic characteristics, self-reported antibiotic prescription and patients...

  6. Assessment of respiratory symptoms and lung function among textile ...

    The smokers among the exposed and unexposed workers had significantly lower lung function values than nonsmokers. Conclusion: Respiratory symptoms were more prevalent among workers in most dusty sections of the factory. Use of protective mask should be enforced. Workers in the spinning and weaving sections of ...

  7. Impact of aerosol on respiratory symptoms among adults (above ...

    Over the past two decades there has been increasing interest in studies of air pollution and its effects on human. The purpose of this study is to assess the prevalence of respiratory symptoms and to relate these measures to the degree of air pollution in an urban area (Sapele) and to establish a relationship between peak ...

  8. Effect of Oral Prednisolone on Symptom Duration and Severity in Nonasthmatic Adults With Acute Lower Respiratory Tract Infection: A Randomized Clinical Trial.

    Hay, Alastair D; Little, Paul; Harnden, Anthony; Thompson, Matthew; Wang, Kay; Kendrick, Denise; Orton, Elizabeth; Brookes, Sara T; Young, Grace J; May, Margaret; Hollinghurst, Sandra; Carroll, Fran E; Downing, Harriet; Timmins, David; Lafond, Natasher; El-Gohary, Magdy; Moore, Michael

    2017-08-22

    Acute lower respiratory tract infection is common and often treated inappropriately in primary care with antibiotics. Corticosteroids are increasingly used but without sufficient evidence. To assess the effects of oral corticosteroids for acute lower respiratory tract infection in adults without asthma. Multicenter, placebo-controlled, randomized trial (July 2013 to final follow-up October 2014) conducted in 54 family practices in England among 401 adults with acute cough and at least 1 lower respiratory tract symptom not requiring immediate antibiotic treatment and with no history of chronic pulmonary disease or use of asthma medication in the past 5 years. Two 20-mg prednisolone tablets (n = 199) or matched placebo (n = 202) once daily for 5 days. The primary outcomes were duration of moderately bad or worse cough (0 to 28 days; minimal clinically important difference, 3.79 days) and mean severity of symptoms on days 2 to 4 (scored from 0 [not affected] to 6 [as bad as it could be]; minimal clinically important difference, 1.66 units). Secondary outcomes were duration and severity of acute lower respiratory tract infection symptoms, duration of abnormal peak flow, antibiotic use, and adverse events. Among 401 randomized patients, 2 withdrew immediately after randomization, and 1 duplicate patient was identified. Among the 398 patients with baseline data (mean age, 47 [SD, 16.0] years; 63% women; 17% smokers; 77% phlegm; 70% shortness of breath; 47% wheezing; 46% chest pain; 42% abnormal peak flow), 334 (84%) provided cough duration and 369 (93%) symptom severity data. Median cough duration was 5 days (interquartile range [IQR], 3-8 days) in the prednisolone group and 5 days (IQR, 3-10 days) in the placebo group (adjusted hazard ratio, 1.11; 95% CI, 0.89-1.39; P = .36 at an α = .05). Mean symptom severity was 1.99 points in the prednisolone group and 2.16 points in the placebo group (adjusted difference, -0.20; 95% CI, -0.40 to 0.00; P = .05

  9. Pertussis (Whooping Cough) Outbreaks

    ... of Search Controls Search Form Controls Cancel Submit Pertussis (Whooping Cough) Note: Javascript is disabled or is not supported ... message, please visit this page: About CDC.gov . Pertussis Home About Pertussis Causes & Transmission Signs & Symptoms Complications ...

  10. Pertussis (Whooping Cough) Complications

    ... of Search Controls Search Form Controls Cancel Submit Pertussis (Whooping Cough) Note: Javascript is disabled or is not supported ... message, please visit this page: About CDC.gov . Pertussis Home About Pertussis Causes & Transmission Signs & Symptoms Complications ...

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

    GI Skoufi

    2013-04-01

    Full Text Available Background: Hairdressers are occupationally exposed to a number of agents in their workplace that result in respiratory symptoms and changes in pulmonary function. Objective: To evaluate associations between occupational exposure and respiratory function and reported symptoms in a group of hairdressers compared to a control group. Methods: A questionnaire on respiratory symptoms and workplace characteristics was completed by 94 hairdressers and 39 age- and sex-matched controls. Spirometry and exhaled nitric oxide (FeNO measurements were also performed. Results: Hairdressers reported more severe dyspnea (p=0.03 and eye (p=0.001 and throat (p=0.007 irritation, compared to the control group, at the workplace; no differences were noted at home. Lower FEV1/FVC (p<0.001 and higher FeNO values (p=0.012 were observed in hairdressers. A larger working area and presence of window ventilation were associated with better pulmonary function. Conclusion: Worsening of symptoms and pulmonary function at workplace, and alleviating the symptoms at home, indicate that they may be related to occupational exposure.

  12. Respiratory and dermal symptoms in Thai nurses using latex products.

    Supapvanich, C; Povey, A C; de Vocht, F

    2013-09-01

    Despite known health risks related to the use of powdered latex gloves (PLGs), they are still widely used in hospitals in developing countries due to the high cost of alternatives. To determine the prevalence of dermal and respiratory symptoms associated with latex glove use in nurses in Thailand and evaluate the influence of previously reported occupational risk factors in this population. A cross-sectional study in female nurses working in three Thai hospitals. Participants completed a questionnaire on demographics, occupational and personal history, use of latex products at work and dermal and respiratory symptoms attributed to occupational use of latex gloves. Of 899 nurses, 18% reported health effects attributed to the use of latex products. After adjustment for confounding, occupational risk factors associated with increased reporting of dermal symptoms included wearing more than 15 pairs of PLG per day (odds ratio (OR): 2.10, 95% confidence interval (CI): [1.32-3.34]), using chlorhexidine (OR: 2.07, 95% CI: [1.22-3.52]) and being an operating theatre nurse (OR: 2.46, 95% CI: [1.47-4.12]). Being a labour ward nurse (OR: 3.52, 95% CI: [1.26-9.85]) was the only factor associated with increased reporting of respiratory symptoms. Continuing use of PLGs in Thai nurses is associated with increased prevalence of dermal symptoms compared with data from developed countries. Measures to reduce such health effects are well established and should be considered. Additionally, replacement of chlorhexidine with an alternative detergent seems advisable.

  13. [Pertussis (Whooping cough)--an update].

    Stock, Ingo

    2015-12-01

    Whooping cough is a highly contagious respiratory disease which is caused predominantly by the gram-negative bacterium Bordetella pertussis. Further Bordetella species such as B. parapertussis and the recently discovered species B. holmesii are also involved in whooping cough-like diseases. Depending on age, vaccination status and distance to pre-infection with B. pertussis, whooping cough shows a wide range of symptoms. The disease occurs at any age, leaving only short time immunity. During the last 15 years, in industrialized countries the number of reported pertussis cases has been increased markedly. The reason for this observation is still unclear Macrolides such as azithromycin and clarithromycin are regarded as antibiotics of first choice. In Germany, combination vaccines containing acellular pertussis vaccines is the most important strategy of prevention. To ensure the best possible protection against pertussis, booster doses at determined times should be given after primary vaccination in infancy.

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

    Luize Barbosa Antunes

    2016-06-01

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

  15. Prevalence of gastro-oesophageal reflux disease symptoms and reflux-associated respiratory symptoms in asthma

    2010-01-01

    Background Gastro-oesophageal reflux disease (GORD) symptoms are common in asthma and have been extensively studied, but less so in the Asian continent. Reflux-associated respiratory symptoms (RARS) have, in contrast, been little-studied globally. We report the prevalence of GORD symptoms and RARS in adult asthmatics, and their association with asthma severity and medication use. Methods A cross-sectional analytical study. A validated interviewer-administered GORD scale was used to assess frequency and severity of seven GORD symptoms. Subjects were consecutive asthmatics attending medical clinics. Controls were matched subjects without respiratory symptoms. Results The mean (SD) composite GORD symptom score of asthmatics was significantly higher than controls (21.8 (17.2) versus 12.0 (7.6); P < 0.001) as was frequency of each symptom and RARS. Prevalence of GORD symptoms in asthmatics was 59.4% (95% CI, 59.1%-59.6%) versus 28.5% in controls (95% CI, 29.0% - 29.4%). 36% of asthmatics experienced respiratory symptoms in association with both typical and atypical GORD symptoms, compared to 10% of controls (P < 0.001). An asthmatic had a 3.5 times higher risk of experiencing a GORD symptom after adjusting for confounders (OR 3.5; 95% CI 2.5-5.3). Severity of asthma had a strong dose-response relationship with GORD symptoms. Asthma medication use did not significantly influence the presence of GORD symptoms. Conclusions GORD symptoms and RARS were more prevalent in a cohort of Sri Lankan adult asthmatics compared to non-asthmatics. Increased prevalence of RARS is associated with both typical and atypical symptoms of GORD. Asthma disease and its severity, but not asthma medication, appear to influence presence of GORD symptoms. PMID:20843346

  16. Contribution of nitrogen oxide and sulfur dioxide exposure from power plant emissions on respiratory symptom and disease prevalence

    Amster, Eric D.; Haim, Maayan; Dubnov, Jonathan; Broday, David M.

    2014-01-01

    This study investigates the association between exposure to ambient NO x and SO 2 originating from power plant emissions and prevalence of obstructive pulmonary disease and related symptoms. The Orot Rabin coal-fired power plant is the largest power generating facility in the Eastern Mediterranean. Two novel methods assessing exposure to power plant-specific emissions were estimated for 2244 participants who completed the European Community Respiratory Health Survey. The “source approach” modeled emissions traced back to the power plant while the “event approach” identified peak exposures from power plant plume events. Respiratory symptoms, but not prevalence of asthma and COPD, were associated with estimates of power plant NO x emissions. The “source approach” yielded a better estimate of exposure to power plant emissions and showed a stronger dose–response relationship with outcomes. Calculating the portion of ambient pollution attributed to power plants emissions can be useful for air quality management purposes and targeted abatement programs. -- Highlights: • Two methods assessing NO x and SO 2 exposure attributed to a coal-fired power plant are utilized. • Exposure estimates are compared with respiratory outcomes in 2244 participants. • Power plant nitrogen oxide emissions are associated with respiratory symptoms. • Stack emission models correlated closest with health outcomes. -- Chronic cough, nocturnal dyspnea, chronic phlegm, and shortness of breath were significantly associated with exposure estimates of power plant-specific NO x emissions

  17. Respiratory symptoms and bronchial responsiveness in competitive swimmers.

    Stadelmann, Katrin; Stensrud, Trine; Carlsen, Kai-Haakon

    2011-03-01

    A high prevalence of bronchial hyperresponsiveness (BHR) and respiratory symptoms has been reported among competitive swimmers. From the 2002 Winter Olympics, BHR measurements or bronchodilator reversibility have been required for approved use of β2-agonists in sports. The first aim of this study was to evaluate the relationship among respiratory symptoms in young elite swimmers, eucapnic voluntary hyperpnea (EVH), and the inhaled dose of methacholine, causing a 20% decrease in forced expiratory volume in 1 s (FEV1; PD(20 methacholine)). The second aim of this study was to assess the repeatability of the EVH test. For this study, 15 male and 9 female adolescent elite swimmers, aged 15 to 25 yr, performed one PD(20 methacholine) test and two EVH tests in a randomized order. Dry air containing 5% CO2 was inhaled for 6 min with a target ventilation of ≥85% of maximum voluntary ventilation (minimum = 65%). PD(20 methacholine) ≤2 μmol and EVH with FEV1 reduction ≥10% were considered positive. Respiratory symptoms and medication were reported in the modified AQUA2008 questionnaire. Twenty swimmers (83%) reported respiratory symptoms, 13 (65%) of them had a positive provocation test. Fourteen (58%) had at least one positive test to either EVH or PD(20 methacholine); three had only one positive EVH test. One athlete had BHR without symptoms. The sensitivity of PD(20 methacholine) ≤2 μmol for respiratory symptoms was 50% versus 60% and 47.37% for the two EVH tests, respectively, and 75% for PD(20 methacholine) ≤4 μmol. The Bland-Altman plot of the two EVH tests showed a consistent distribution, with only one subject outside the limits of agreement. BHR was frequently found among adolescent competitive swimmers. PD(20 methacholine) ≤2 μmol and EVH ≥ 10% compared well, but PD(20 methacholine) ≤4 μmol had the highest sensitivity for respiratory symptoms. The EVH test has high repeatability but is very expensive and uncomfortable to perform.

  18. Respiratory symptoms and pulmonary function tests in security and safety products plant workers.

    Balbay, Ege Gulec; Toru, Umran; Arbak, Peri; Balbay, Oner; Suner, Kezban Ozmen; Annakkaya, Ali Nihat

    2014-01-01

    Lock and key factory workers are under the risk of metal pneumoconiosis and occupational asthma. In this cross-sectional study, it's aimed to evaluate the relationship between metal dust exposure and respiratory symptoms, pulmonary function tests of workers in different section of lock and key factory. 54 male workers (mean age, 32.8 ± 5.4) in a security and safety products plant were evaluated for respiratory symptoms, pulmonary function tests and smoking habits. Results have been interpreted by comparison of the painting (28/54) and grinding group workers (26/54). There was no significant difference between painting (32.1 ± 4.8) and grinding (33.6 ± 6.1) groups regarding mean age (P > 0.05). Smokers were in significantly higher in grinding group (18/26). Cough and sputum were reported 14.3% (4/28) in painting and 3.8% (1/26) in grinding workers (P > 0.05). Chest tightness was seen in 7.1% and 7.7% of painting and grinding workers, respectively (P > 0.05). But no chest tightness was reported in both groups when they were away work. Breathlessness was seen in 10.7% and 7.7% of painting and grinding workers, respectively (P > 0.05). Breathlessness was similar in both groups (7.1% vs. 3.8%) when they were away work. When comparing painting and grinding workers respiratory functions no significant difference observed. Chest radiography in painting and grinding workers showed hyperlucency (3.6% vs.11.4%), respectively. Painting groups in lock and key factory workers had more but statistically insignificantrespiratory complaints. Interestingly, chest tightness was only observed when both groups were at work. It was thought that ventilation and using personal protective equipment in factory could provide significant benefits.

  19. Respiratory Health Symptoms among Students Exposed to Different Levels of Air Pollution in a Turkish City

    Günay Güngör

    2011-04-01

    Full Text Available In this study, we aimed to investigate the frequency of respiratory health symptoms among high school students attending schools at industrial, urban and rural areas in a Turkish city. Three schools located in different zones of the city having different pollution characteristics were chosen based on the pollutant distribution maps using Geographical Information Systems (GIS software. A cross-sectional survey was performed among 667 high school students in the schools. Outdoor and indoor nitrogen dioxide (NO2 and ozone (O3 concentrations were also measured by passive samplers in the same schools to investigate possible routes of exposure. Chronic pulmonary disease (OR = 1.49; 95%CI: 1.11–1.99; p = 0.008, tightness in the chest (OR = 1.57; 95%CI: 1.22–2.02; p = 0.001, morning cough (OR = 1.81 95%CI: 1.19–2.75; p = 0.006 were higher among students in the industrial zone where nitrogen dioxide and ozone levels were also highest. There were no indoor sources of nitrogen dioxide and ozone exists in the schools except for the dining hall. As a conclusion, this study has noticed that air pollution and respiratory health problems among high school students are high in industrial zones and the use of passive samplers combined with GIS is an effective tool that may be used by public health researchers to identify pollutant zones and persons at risk.

  20. Prevalence of bronchial asthma and respiratory symptoms in a group of students from grodno. An example of standardized epidemiological survey

    Oleg Ahiyevets

    2017-01-01

    Full Text Available Introduction: Due to an insufficient knowledge of the real asthma prevalence rate among children and adults in Belarus, we conducted a population-based respiratory health survey. Aim of the study: The study aimed at estimating the prevalence rate of asthma and major respiratory symptoms among students of the Grodno Region (Western Belarus. Material and methods: The cross-sectional study was conducted in 2014 and included 833 students aged 20-40 (young adults. Physician-diagnosed respiratory diseases and symptoms were ascertained using electronic version of the ISAAC questionnaire (web LimeSurvey. Results: The prevalence of asthma was 2.88% (physician-diagnosed. The obstructive (asthmatic bronchitis (without established diagnosis of asthma was found in 5.04% of the respondents. A chronic respiratory symptom occurring in the past 12 months and suggestive of asthma included attacks of dyspnea at rest, cough (5.88% or in previous periods (8.88%, and wheezing in the chest (one of the most characteristic symptoms of asthma - 8.04%, which may indicate a higher prevalence of asthma among patients. Wheezing and wheeze without diagnosed asthma, colds or infections were reported in a small number of cases (about 1.0%. 32 respondents (3.84% can be attributed to the group of risk for asthma due to the presence of specific respiratory symptoms. Conclusions: The findings show a low prevalence of physician-diagnosed asthma among students of Western Belarus. Relatively low prevalence of allergic disorders among respondents of Belarus suggest underdiagnosis of allergic diseases, in particular of asthma. Presumably, cases of asthma might be diagnosed as spastic bronchitis, “obstructive bronchitis”, “asthmatic bronchitis”, a traditional label for clinical manifestation of asthma in medical practice in the region.

  1. To compare the effect of dextromethorphan, promethazine and placebo on nocturnal cough in children aged 1-12 y with upper respiratory infections: a randomized controlled trial.

    Bhattacharya, Malobika; Joshi, Neha; Yadav, Sangita

    2013-11-01

    To evaluate whether promethazine and dextromethorphan reduce nocturnal cough and improve sleep quality in children aged 1-12 y with upper respiratory tract infection (URI). This randomised double-blinded placebo-controlled trial was conducted in Pediatric outpatient department of Lok Nayak Hospital, Delhi. After randomization into promethazine, dextromethorphan and placebo groups, parental assessment of 120 children with URI for nocturnal cough severity (child), post-tussive vomiting (child) and sleep quality (child and parent) on the night before enrolment and after 3 d of assigned medication was measured using an internally validated indigenously prepared ordinal scale. Entire cohort improved in all the study parameters after 3 d. However, no superior benefit was noted when individual parameters were compared in the promethazine and dextromethorphan groups with the placebo group. Adverse effects were more frequent in the dextromethorphan and promethazine groups although the difference was not statistically significant. Nocturnal cough in URI is self-resolving and dextromethorphan and promethazine prescribed for the same are not superior to placebo.

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

    Rouba Zeidan

    2014-08-01

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

  3. The effect of exposure to biomass smoke on respiratory symptoms in adult rural and urban Nepalese populations.

    Kurmi, Om P; Semple, Sean; Devereux, Graham S; Gaihre, Santosh; Lam, Kin Bong Hubert; Sadhra, Steven; Steiner, Markus F C; Simkhada, Padam; Smith, William C S; Ayres, Jon G

    2014-11-06

    Half of the world's population is exposed to household air pollution from biomass burning. This study aimed to assess the relationship between respiratory symptoms and biomass smoke exposure in rural and urban Nepal. A cross-sectional study of adults (16+ years) in a rural population (n = 846) exposed to biomass smoke and a non-exposed urban population (n = 802) in Nepal. A validated questionnaire was used along with measures of indoor air quality (PM2.5 and CO) and outdoor PM2.5. Both men and women exposed to biomass smoke reported more respiratory symptoms compared to those exposed to clean fuel. Women exposed to biomass were more likely to complain of ever wheeze (32.0 % vs. 23.5%; p = 0.004) and breathlessness (17.8% vs. 12.0%, p = 0.017) compared to males with tobacco smoking being a major risk factor. Chronic cough was similar in both the biomass and non-biomass smoke exposed groups whereas chronic phlegm was reported less frequently by participants exposed to biomass smoke. Higher PM2.5 levels (≥2 SDs of the 24-hour mean) were associated with breathlessness (OR = 2.10, 95% CI 1.47, 2.99) and wheeze (1.76, 1.37, 2.26). The study suggests that while those exposed to biomass smoke had higher prevalence of respiratory symptoms, urban dwellers (who were exposed to higher ambient air pollution) were more at risk of having productive cough.

  4. Current issues in the respiratory care of patients with amyotrophic lateral sclerosis

    Marco Orsini

    2015-10-01

    Full Text Available Amyotrophic lateral sclerosis is a progressive neuromuscular disease, resulting in respiratory muscle weakness, reduced pulmonary volumes, ineffective cough, secretion retention, and respiratory failure. Measures as vital capacity, maximal inspiratory and expiratory pressures, sniff nasal inspiratory pressure, cough peak flow and pulse oximetry are recommended to monitor the respiratory function. The patients should be followed up by a multidisciplinary team, focused in improving the quality of life and deal with the respiratory symptoms. The respiratory care approach includes airway clearance techniques, mechanically assisted cough and noninvasive mechanical ventilation. Vaccination and respiratory pharmacological support are also recommended. To date, there is no enough evidence supporting the inspiratory muscle training and diaphragmatic pacing.

  5. Tic disorders in the differential diagnosis of chronic cough in children in relation to four cases.

    Karakaya, Işık; Şişmanlar, Şahika Gülen

    2015-09-01

    Chronic cough is a frequent reason for medical referrals in childhood. In patients who do not have signs or symptoms of an underlying respiratory system disease and who do not respond to experimental treatment, psychogenic cough should be considered. In this paper, four patients who were referred to our department with a prediagnosis of psychogenic cough, found to have tic disorder as a result of the assessments performed and improved with antipsychotic medication are presented. The differantial diagnosis of chronic cough in children should include tic disorders as well as psychogenic cough. Tic disorders can be diagnosed easily with detailed history and their response to medical treatment is rather satisfactory. Recognition of these disorders by pediatricians will minimize erroneous diagnoses and inappropriate therapies in children with a complaint of chronic cough.

  6. The effect of chemical warfare on respiratory symptoms, pulmonary function tests and their reversibility 23-25 years after exposure.

    Boskabady, Mrteza; Boskabady, Mohammad Hossein; Zabihi, Narges Amel; Boskabady, Marzie

    2015-01-01

    Pulmonary complications due to mustard gas exposure range from no effect to severe bronchial stenosis. Pulmonary function tests (PFTs) and respiratory symptoms in chemical war victims were studied 23-25 years after exposure to sulfur mustard (SM). Respiratory symptoms were evaluated in a sample of 142 chemical war victims and 120 control subjects with similar age from the general population using a questionnaire including questions on respiratory symptoms in the past year. PFT values were also measured in chemical war victims before and 15 min after the inhalation of 200 µg salbutamol and baseline PFT in controls. All chemical war victims (100%) reported respiratory symptoms. Wheezing (66.19%), cough (64.78%), and chest tightness (54.4%) were the most common symptoms and only 15.5% of chemical war victims reported sputum (p chemical war victims had wheeze in chest examination, which were significantly higher than control group (p chemical war victims than that in control subjects (p chemical war victims, 23-25 years after exposure to chemical warfare have higher frequencies and severity of respiratory symptoms. PFT values were also significantly reduced among chemical war victims, which showed reversibility due to the inhalation of 200 µg salbutamol. © The Author(s) 2012.

  7. Prevalence of gastro-oesophageal reflux disease symptoms and reflux-associated respiratory symptoms in asthma

    de Silva H Janaka

    2010-09-01

    Full Text Available Abstract Background Gastro-oesophageal reflux disease (GORD symptoms are common in asthma and have been extensively studied, but less so in the Asian continent. Reflux-associated respiratory symptoms (RARS have, in contrast, been little-studied globally. We report the prevalence of GORD symptoms and RARS in adult asthmatics, and their association with asthma severity and medication use. Methods A cross-sectional analytical study. A validated interviewer-administered GORD scale was used to assess frequency and severity of seven GORD symptoms. Subjects were consecutive asthmatics attending medical clinics. Controls were matched subjects without respiratory symptoms. Results The mean (SD composite GORD symptom score of asthmatics was significantly higher than controls (21.8 (17.2 versus 12.0 (7.6; P P Conclusions GORD symptoms and RARS were more prevalent in a cohort of Sri Lankan adult asthmatics compared to non-asthmatics. Increased prevalence of RARS is associated with both typical and atypical symptoms of GORD. Asthma disease and its severity, but not asthma medication, appear to influence presence of GORD symptoms.

  8. Two deletion variants of Middle East respiratory syndrome coronavirus found in a patient with characteristic symptoms.

    Xie, Qian; Cao, Yujuan; Su, Juan; Wu, Jie; Wu, Xianbo; Wan, Chengsong; He, Mingliang; Ke, Changwen; Zhang, Bao; Zhao, Wei

    2017-08-01

    Significant sequence variation of Middle East respiratory syndrome coronavirus (MERS CoV) has never been detected since it was first reported in 2012. A MERS patient came from Korea to China in late May 2015. The patient was 44 years old and had symptoms including high fever, dry cough with a little phlegm, and shortness of breath, which are roughly consistent with those associated with MERS, and had had close contact with individuals with confirmed cases of MERS.After one month of therapy with antiviral, anti-infection, and immune-enhancing agents, the patient recovered in the hospital and was discharged. A nasopharyngeal swab sample was collected for direct sequencing, which revealed two deletion variants of MERS CoV. Deletions of 414 and 419 nt occurred between ORF5 and the E protein, resulting in a partial protein fusion or truncation of ORF5 and the E protein. Functional analysis by bioinformatics and comparison to previous studies implied that the two variants might be defective in their ability to package MERS CoV. However, the mechanism of how these deletions occurred and what effects they have need to be further investigated.

  9. The effect of industry-related air pollution on lung function and respiratory symptoms in school children.

    Bergstra, Arnold D; Brunekreef, Bert; Burdorf, Alex

    2018-03-27

    Heavy industry emits many potentially hazardous pollutants into the air which can affect health. However, the effects of air pollution from heavy industry on lung function and respiratory symptoms have been investigated scarcely. Our aim was to investigate the associations of long-term air pollution from heavy industry with lung function and respiratory symptoms in school children. A cross-sectional lung function study was conducted among school children (7-13 years) in the vicinity of an area with heavy industry. Lung function measurements were conducted during school hours. Parents of the children were asked to complete a questionnaire about the health of their children. A dispersion model was used to characterize the additional individual-level exposures to air pollutants from the industry in the area. Associations between PM 2.5 and NO X exposure with lung function and presence of respiratory symptoms were investigated by linear and/or logistic regression analysis. Participation in the lung function measurements and questionnaires was 84% (665/787) and 77% (603/787), respectively. The range of the elevated PM 2.5 and NO X five years average concentrations (2008-2012) due to heavy industry were 0.04-1.59 μg/m 3 and 0.74-11.33 μg/m 3 respectively. After adjustment for confounders higher exposure to PM 2.5 and NO X (per interquartile range of 0.56 and 7.43 μg/m 3 respectively) was associated with lower percent predicted peak expiratory flow (PEF) (B -2.80%, 95%CI -5.05% to - 0.55% and B -3.67%, 95%CI -6.93% to - 0.42% respectively). Higher exposure to NO X (per interquartile range of 7.43 μg/m 3 ) was also associated with lower percent forced vital capacity (FVC) and percent predicted forced expiration volume in 1 s (FEV1) (B -2.30, 95% CI -4.55 to - 0.05 and B -2.73, 95%CI -5.21 to - 0.25 respectively). No significant associations were found between the additional exposure to PM 2.5 or NO X and respiratory symptoms except for PM 2.5 and dry

  10. Does smoking status affect the likelihood of consulting a doctor about respiratory symptoms? A pilot survey in Western Australia

    O'Connor Moira

    2009-02-01

    Full Text Available Abstract Background Smokers attribute respiratory symptoms, even when severe, to everyday causes and not as indicative of ill-health warranting medical attention. The aim of this pilot study was to conduct a structured vignette survey of people attending general practice to determine when they would advise a person with respiratory symptoms to consult a medical practitioner. Particular reference was made to smoking status and lung cancer. Methods Participants were recruited from two general practices in Western Australia. Respondents were invited to complete self-administered questionnaires containing nine vignettes chosen at random from a pool of sixty four vignettes, based on six clinical variables. Twenty eight vignettes described cases with at least 5% risk of cancer. For analysis these were dubbed 'cancer vignettes'. Respondents were asked if they would advise a significant other to consult a doctor with their respiratory symptoms. Logistic regression and non-parametric tests were used to analyse the data. Results Three hundred questionnaires were distributed and one hundred and forty completed responses were collected over six weeks. The majority (70.3% of respondents were female aged forty and older. A history of six weeks' of symptoms, weight loss, cough and breathlessness independently increased the odds of recommending a consultation with a medical practitioner by a factor of 11.8, 2.11, 1.40 and 4.77 respectively. A history of smoking independently increased the odds of the person being thought 'likely' or 'very likely' to have cancer by a factor of 2.46. However only 32% of cancer vignettes with a history of cigarette smoking were recognised as presentations of possible cancer. Conclusion Even though a history of cigarette smoking was more likely to lead to the suggestion that a symptomatic person may have cancer we did not confirm that smokers would be more likely to be advised to consult a doctor, even when presenting with common

  11. High prevalence of respiratory symptoms among workers in the development section of a manually operated coal mine in a developing country: A cross sectional study

    Bråtveit Magne

    2007-02-01

    Full Text Available Abstract Background Few studies of miners have been carried out in African countries; most are from South Africa, where the working conditions are assumed to be better than in the rest of Africa. Several studies have focused on respiratory disorders among miners, but development workers responsible for creating underground road ways have not been studied explicitly. This is the first study assessing the associations between exposure to dust and quartz and respiratory symptoms among coal mine workers in a manually operated coal mine in Tanzania, focusing on development workers, as they have the highest exposure to coal dust. Methods A cross-sectional study was carried out among 250 production workers from a coal mine. Interviews were performed using modified standardized questionnaires to elicit information on occupational history, demographics, smoking habits and acute and chronic respiratory symptoms. The relationships between current dust exposure as well as cumulative respirable dust and quartz and symptoms were studied by group comparisons as well as logistic regression. Results Workers from the development group had the highest dust exposure, with arithmetic mean of 10.3 mg/m3 for current respirable dust and 1.268 mg/m3 for quartz. Analogous exposure results for mine workers were 0.66 mg/m3 and 0.03 mg/m3, respectively; and for other development workers were 0.88 mg/m3 and 0.10 mg/m3, respectively. The workers from the development section had significantly higher prevalence of the acute symptoms of dry cough (45.7%, breathlessness (34.8% and blocked nose (23.9%. In addition, development workers had significantly more chronic symptoms of breathlessness (17.0% than the mine workers (6.4% and the other production workers (2.4%. The highest decile of cumulative exposure to respirable dust was significantly associated with cough (OR = 2.91, 95% CI 1.06, 7.97 as were cumulative exposure to quartz and cough (OR = 2.87, CI 1.05, 7.88, compared with

  12. Respiratory Symptoms and Lung Function in Poultry Confinement Workers in Western Canada

    Shelley P Kirychuk

    2003-01-01

    Full Text Available OBJECTIVE: To determine whether poultry production methods impact respiratory health, and whether poultry farmers have more respiratory symptoms and lower lung function than comparison control groups.

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

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

    2007-01-01

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

  14. Cough event classification by pretrained deep neural network.

    Liu, Jia-Ming; You, Mingyu; Wang, Zheng; Li, Guo-Zheng; Xu, Xianghuai; Qiu, Zhongmin

    2015-01-01

    Cough is an essential symptom in respiratory diseases. In the measurement of cough severity, an accurate and objective cough monitor is expected by respiratory disease society. This paper aims to introduce a better performed algorithm, pretrained deep neural network (DNN), to the cough classification problem, which is a key step in the cough monitor. The deep neural network models are built from two steps, pretrain and fine-tuning, followed by a Hidden Markov Model (HMM) decoder to capture tamporal information of the audio signals. By unsupervised pretraining a deep belief network, a good initialization for a deep neural network is learned. Then the fine-tuning step is a back propogation tuning the neural network so that it can predict the observation probability associated with each HMM states, where the HMM states are originally achieved by force-alignment with a Gaussian Mixture Model Hidden Markov Model (GMM-HMM) on the training samples. Three cough HMMs and one noncough HMM are employed to model coughs and noncoughs respectively. The final decision is made based on viterbi decoding algorihtm that generates the most likely HMM sequence for each sample. A sample is labeled as cough if a cough HMM is found in the sequence. The experiments were conducted on a dataset that was collected from 22 patients with respiratory diseases. Patient dependent (PD) and patient independent (PI) experimental settings were used to evaluate the models. Five criteria, sensitivity, specificity, F1, macro average and micro average are shown to depict different aspects of the models. From overall evaluation criteria, the DNN based methods are superior to traditional GMM-HMM based method on F1 and micro average with maximal 14% and 11% error reduction in PD and 7% and 10% in PI, meanwhile keep similar performances on macro average. They also surpass GMM-HMM model on specificity with maximal 14% error reduction on both PD and PI. In this paper, we tried pretrained deep neural network in

  15. Prevalence of asthma symptoms based on the european community respiratory health survey questionnaire and FENO in university students: gender differences in symptoms and FENO

    Ishizuka Tamotsu

    2011-09-01

    Full Text Available Abstract Background The fractional concentration of nitric oxide in exhaled air (FENO is used as a biomarker of eosinophilic airway inflammation. FENO is increased in patients with asthma. The relationship between subjective asthma symptoms and airway inflammation is an important issue. We expected that the subjective asthma symptoms in women might be different from those in men. Therefore, we investigated the gender differences of asthma symptoms and FENO in a survey of asthma prevalence in university students. Methods The information about asthma symptoms was obtained from answers to the European Community Respiratory Health Survey (ECRHS questionnaire, and FENO was measured by an offline method in 640 students who were informed of this study and consented to participate. Results The prevalence of asthma symptoms on the basis of data obtained from 584 students (266 men and 318 women, ranging in age from 18 to 24 years, was analyzed. Wheeze, chest tightness, an attack of shortness of breath, or an attack of cough within the last year was observed in 13.2% of 584 students. When 38.0 ppb was used as the cut-off value of FENO to make the diagnosis of asthma, the sensitivity was 86.8% and the specificity was 74.0%. FENO was ≥ 38.0 ppb in 32.7% of students. FENO was higher in men than in women. The prevalence of asthma symptoms estimated by considering FENO was 7.2%; the prevalence was greater in men (9.4% than women (5.3%. A FENO ≥ 38.0 ppb was common in students who reported wheeze, but not in students, especially women, who reported cough attacks. Conclusions The prevalence of asthma symptoms in university students age 18 to 24 years in Japan was estimated to be 7.2% on the basis of FENO levels as well as subjective symptoms. Gender differences were observed in both FENO levels and asthma symptoms reflecting the presence of eosinophilic airway inflammation. Trial registration number UMIN000003244

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

    Jalaludin, Bin B.; O'Toole, Brian I.; Leeder, Stephen R.

    2004-01-01

    We enrolled a cohort of primary school children with a history of wheeze (n=148) in an 11-month longitudinal study to examine the relationship between ambient air pollution and respiratory morbidity. We obtained daily air pollution (ozone, particulate matter less than 10 μm, and nitrogen dioxide), meteorological, and pollen data. One hundred twenty-five children remained in the final analysis. We used logistic regression models to determine associations between air pollution and respiratory symptoms, asthma medication use, and doctor visits for asthma. There were no associations between ambient ozone concentrations and respiratory symptoms, asthma medication use, and doctor visits for asthma. There was, however, an association between PM 10 concentrations and doctor visits for asthma (RR=1.11, 95% CI=1.04-1.19) and between NO 2 concentration and wet cough (RR=1.05, 95% CI=1.003-1.10) in single-pollutant models. The associations remained significant in multipollutant models. There was no consistent evidence that children with wheeze, positive histamine challenge, and doctor diagnosis of asthma reacted differently to air pollution from children with wheeze and doctor diagnosis of asthma and children with wheeze only. There were significant associations between PM 10 levels and doctor visits for asthma and an association between NO 2 levels and the prevalence of wet cough. We were, however, unable to demonstrate that current levels of ambient air pollution in western Sydney have a coherent range of adverse health effects on children with a history of wheezing

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

    Laura Russo Zillmer

    2014-12-01

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

  18. Respiratory symptoms and bronchial responsiveness are related to dietary salt intake and urinary potassium excretion in male children.

    Pistelli, R; Forastiere, F; Corbo, G M; Dell'Orco, V; Brancato, G; Agabiti, N; Pizzabiocca, A; Perucci, C A

    1993-04-01

    To investigate whether dietary salt intake and urinary sodium and potassium levels are related to respiratory symptoms and bronchial responsiveness, a cross-sectional study among 2593 subjects aged 9 to 16 was conducted in four communities of the Latium region (Italy). Questionnaires were administered to the parents, urine samples were collected, lung function, methacholine challenge tests and prick tests were performed. Information about familial and personal dietary salt use and respiratory health was collected from the parents of 2439 (94%) subjects. A total of 2020 methacholine challenge tests and 916 urinary sodium and potassium levels were available for analysis. Personal table salt use was strongly related to cough and phlegm apart from colds (adjusted odds ratios, OR, 1.87, 95% confidence intervals, CI, 1.20-2.90), wheezing apart from colds (OR, 2.19, 95% CI, 1.27-3.77), wheezing with dyspnoea (OR, 1.45, 95% CI, 0.98-2.12) and wheezing after exercise (OR, 2.16, 95% CI, 1.35-3.44). These associations were mainly found in boys. Use of familial table salt and canned food showed no relation to respiratory symptoms. Increased bronchial responsiveness was associated with a higher urinary potassium excretion in boys, but not with urinary sodium. In conclusion, personal table salt use is related to an increased prevalence of bronchial symptoms; an increase in bronchial responsiveness among those with higher potassium excretion also seems to be implied. Although it is difficult to interpret the results of this study in causal terms, the findings might be relevant to the distribution of bronchial symptoms and diseases in the population.

  19. Respiratory symptoms as health status indicators in workers at ceramics manufacturing facilities.

    Rondon, Edilaura Nunes; Silva, Regina Maria Veras Gonçalves da; Botelho, Clovis

    2011-01-01

    To assess the prevalence of respiratory symptoms and their association with sociodemographic variables and with the characteristics of the work environment. A cross-sectional study comprising 464 workers employed at ceramics manufacturing facilities located in the city of Várzea Grande, Brazil. Data were collected by means of a questionnaire comprising questions regarding sociodemographic variables, work environment characteristics, and respiratory symptoms. Data were analyzed by means of prevalence ratios and their respective 95% CIs between the dependent variable (respiratory symptoms) and the other explanatory variables. In the multivariate analysis, two hierarchical models were built, the response variables being "all respiratory symptoms" and "severe respiratory symptoms". In the sample studied, the prevalence of "all respiratory symptoms" was 78%, whereas that of "severe respiratory symptoms" was 35%. The factors associated with "all respiratory symptoms" were gender, age bracket, level of education, type of occupation, exposure to dust, and exposure to chemical products. The factors associated with "severe respiratory symptoms" were level of education, exposure to dust, and exposure to chemical products. Our results indicate the presence of upper and lower airway disease in the population studied.

  20. Recognizing and Preventing Whooping Cough

    This podcast provides information about the symptoms of whooping cough and how vaccines can help prevent this serious disease for people of all ages. It is especially important for those who will have close contact with a baby to be up to date with their whooping cough vaccine.

  1. Churg-strauss syndrome without respiratory symptoms in a child

    R B Basak

    2011-01-01

    Full Text Available Churg-Strauss Syndrome (CSS is rare in children. It consists of a small- and medium-sized vessel vasculitis, with skin and peripheral nerve involvement. It is characterized by eosinophilia, extravascular necrotizing granuloma, and eosinophilic infiltration of multiple organs particularly the lungs, but may also involve the gastrointestinal tract, the heart, and the kidneys. The condition is usually associated with a preceding history of asthma or allergic sinusitis. It has rarely been reported in children, where most of the cases had pre-existing asthma, allergic rhinitis, or atopic disease. We report a 10-year-old Arab girl proven to have CSS, with no history of asthma or allergic rhinitis, who presented with tender cutaneous nodules of lower extremities, foot drop, and peripheral eosinophilia, without any clinical respiratory symptoms or signs.

  2. Chronic Cough in Otorhinolaryngologic Routine

    Palheta Neto, Francisco Xavier

    2011-04-01

    Full Text Available Introduction: The chronic cough is sometimes manifested as an imprecise symptom, but of great importance for both the diagnosis and the prognosis. In an otorhinolaryngologic approach, several illnesses that can occur with it can be numbered, including 2 of the 3 main causes of chronic cough. Objective: To identify the main otorhinolaryngologic diseases showing the chronic cough as one of their manifestations. Method: A literature's revision was performed in several scientific articles, specialized books and consultation in Birene and Scielo databases. Literature's revision: cough production in the upper airways is usually associated with an inflammatory reaction by stimulating sensitive receptors of these areas or by mechanic stimulus. The main cause of the chronic cough in the otorhinolaryngology day-to-day is the post-nasal drip, gathering together by itself 02 of the most common diseases: rhinitis and sinusitis. Laryngitis as a result of gastroesophageal reflux (GER stands out in the index of chronic cough etiology, but it is not as severe as GER . Neoplasias are also somewhat frequent causes of cough, and the difficulty in diagnosing the cough cause is common in this disease group. Motility disorder, laryngeal irritation persistence, parasitic disease and injuries by inhalation of toxic products were also found as a cause of cough for longer than 03 months. Conclusion:Chronic cough is a frequent and important finding in otorhinolaryngology and cannot be underestimated, and a careful anamnesis is the best way to determine the etiology and perform a correct treatment for the patient's disease.

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

    Thabane Lehana

    2010-03-01

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

  4. Cotton dust exposure and self-reported respiratory symptoms among textile factory workers in Northwest Ethiopia: a comparative cross-sectional study.

    Daba Wami, Sintayehu; Chercos, Daniel Haile; Dessie, Awrajaw; Gizaw, Zemichael; Getachew, Atalay; Hambisa, Tesfaye; Guadu, Tadese; Getachew, Dawit; Destaw, Bikes

    2018-01-01

    Cotton dust induced respiratory disorders are dramatically increased over the globe, especially the problem is serious in developing countries. Respiratory symptoms, such as cough, phlegm, wheezing, shortness of breath, chest tightness, chronic bronchitis, and byssinosis are common among workers exposed to cotton dust. However, in Ethiopia, the magnitude of the problem is not well known and information is limited about the risk factors. Therefore, this study was aimed to assess the prevalence of respiratory symptoms and associated factors. A Comparative cross-sectional study design was employed. A total of 413 (276 exposed and 137 unexposed) participants were included in the study. Stratified and simple random sampling techniques were used to select exposed and unexposed groups to cotton dust respectively. Multivariable binary logistic regression analyses was performed to identify variables associated with respiratory symptoms and adjusted odds ratio (AOR) was used to determine the strength of associations. Significance level was obtained at 95% confidence interval (CI) and p -value ≤0.05. The prevalence of self-reported respiratory symptoms was 47.8% (95% CI: 41.3, 53.7%) and 15.3% (95% CI: 9.6, 22.3%) among exposed and control groups respectively. Sex (AOR = 2.1, 95% CI: 1.29, 3.45), service year (AOR = 2.38, 95% CI: 1.19, 4.71) and ventilation (AOR = 2.4, 95% CI: 1.17, 4.91) were factors significantly associated with respiratory symptoms. Furthermore, working department such as; ginning (AOR = 5.1, 95% CI: 2.13, 12.16), spinning (AOR = 4.96, 95% CI: 2.18, 11.29), weaving (AOR = 5.9, 95% CI: 2.46, 14.27) and blowing working departments (AOR = 5.14, 95% CI: 1.4, 18.94) were significantly associated with respiratory disorders. The prevalence of self-reported respiratory symptoms was higher among workers exposed to cotton dust than unexposed workers. Sex, service year, working department and work unit ventilation were predictor

  5. Predictors of objective cough frequency in chronic obstructive pulmonary disease

    Sumner, Helen; Woodcock, Ashley; Kolsum, Umme

    2013-01-01

    Cough is one of the principal symptoms of chronic obstructive pulmonary disease (COPD) but the potential drivers of cough are likely to be multifactorial and poorly understood.......Cough is one of the principal symptoms of chronic obstructive pulmonary disease (COPD) but the potential drivers of cough are likely to be multifactorial and poorly understood....

  6. Whooping Cough PSA (:30)

    2015-01-22

    This 30 second PSA encourages pregnant women to get the whooping cough vaccine, called Tdap, during the third trimester of each pregnancy in order to pass antibodies to their babies so they are born with protection against this serious disease.  Created: 1/22/2015 by National Center for Immunization and Respiratory Diseases (NCIRD), Division of Bacterial Diseases (DBD), Meningitis and Vaccine Preventable Diseases Branch (MVPDB).   Date Released: 1/22/2015.

  7. Cough quality in children: a comparison of subjective vs. bronchoscopic findings

    Cox Nancy C

    2005-01-01

    Full Text Available Abstract Background Cough is the most common symptom presenting to doctors. The quality of cough (productive or wet vs dry is used clinically as well as in epidemiology and clinical research. There is however no data on the validity of cough quality descriptors. The study aims were to compare (1 cough quality (wet/dry and brassy/non-brassy to bronchoscopic findings of secretions and tracheomalacia respectively and, (2 parent's vs clinician's evaluation of the cough quality (wet/dry. Methods Cough quality of children (without a known underlying respiratory disease undergoing elective bronchoscopy was independently evaluated by clinicians and parents. A 'blinded' clinician scored the secretions seen at bronchoscopy on pre-determined criteria and graded (1 to 6. Kappa (K statistics was used for agreement, and inter-rater and intra-rater agreement examined on digitally recorded cough. A receiver operating characteristic (ROC curve was used to determine if cough quality related to amount of airway secretions present at bronchoscopy. Results Median age of the 106 children (62 boys, 44 girls enrolled was 2.6 years (IQR 5.7. Parent's assessment of cough quality (wet/dry agreed with clinicians' (K = 0.75, 95%CI 0.58–0.93. When compared to bronchoscopy (bronchoscopic secretion grade 4, clinicians' cough assessment had the highest sensitivity (0.75 and specificity (0.79 and were marginally better than parent(s. The area under the ROC curve was 0.85 (95%CI 0.77–0.92. Intra-observer (K = 1.0 and inter-clinician agreement for wet/dry cough (K = 0.88, 95%CI 0.82–0.94 was very good. Weighted K for inter-rater agreement for bronchoscopic secretion grades was 0.95 (95%CI 0.87–1. Sensitivity and specificity for brassy cough (for tracheomalacia were 0.57 and 0.81 respectively. K for both intra and inter-observer clinician agreement for brassy cough was 0.79 (95%CI 0.73–0.86. Conclusions Dry and wet cough in children, as determined by clinicians and

  8. Multi-centre retrospective analysis of clinical diagnosis and treatment for chronic cough

    Xiao-ming CHENG

    2011-02-01

    Full Text Available Objective To explore the clinical characteristics and the present status of diagnosis and treatment of chronic cough.Methods The clinical data of 238 in-patients and out-patients of Departments of Respiratory Diseases from 4 teaching hospitals of Chongqing Municipality were collected from Oct.2008 to Dec.2009,and their clinical characteristics,diagnosis and therapeutic effects were retrospectively analyzed.Results A total of 238 patients were enrolled,most of them complained of dry cough and night cough.Throat symptoms were most common,including itching or foreign body sensation,throat discomfort and gastro-oesophageal reflux.Congestion of pharynx and cobblestone like changes in posterior pharyngeal wall were the most common signs in patients with chronic cough.Among all the supplementary examinations,bronchial provocation test resulted in highest positive rate.Etiological diagnosis was done in a total of 254 case-times for diseases leading to chronic cough,among them upper airway cough syndrome(UACS was suspected in 115 case-times.cough variant asthma(CVA in 42 case-times,and cough due to gastroesophageal reflux(GERC in 53 case-times.After the specific treatment targeting UACS,CVA and GERC,in 152 case-times improvement was found after follow-up,including 56,27 and 21 case-times,respectively,with an effective rate of 68.4%(104/152.The final diagnosis for the other 44 case-times with chronic cough was chronic tonsillitis,chronic bronchitis,eosinophilic bronchitis and angiotensin converting enzyme inhibitor(ACEI induced cough.A definite diagnosis was finally made in 148 out of a total of 254 casses,with a diagnostic rate of 58.3%(148/254.Conclusion The final diagnostic rate in etiology of chronic cough is still poor nowadays in our country,and empirical treatment is still the main practice for chronic cough.

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

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

    2010-01-01

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

  10. Low Respiratory Function Increases the Risk of Depressive Symptoms in Later Life in Men

    Giltay, E.J.; Nissinen, A.; Giampaoli, S.; Zitman, F.G.; Kromhout, D.

    2010-01-01

    Objective: To assess the risk of depressive symptoms with respect to respiratory function in middle-aged men. Chronic lung diseases are associated with a high prevalence of depression, but the association of poor respiratory function with depressive symptoms has not been established in prospective

  11. Association between Occupational Stress and Respiratory Symptoms among Lecturers in Universiti Putra Malaysia

    M. Y., Nur Aqilah; J., Juliana

    2012-01-01

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

  12. The efficacy of the upright position on gastro-esophageal reflux and reflux-related respiratory symptoms in infants with chronic respiratory symptoms.

    Jung, Woo Jin; Yang, Hyeon Jong; Min, Taek Ki; Jeon, You Hoon; Lee, Hae Won; Lee, Jun Sung; Pyun, Bok Yang

    2012-01-01

    Gastro-esophageal reflux (GER), particularly non-acid reflux, is common in infants and is a known cause of chronic respiratory symptoms in infancy. Recent guidelines recommended empirical acid suppression therapy and the head-up position in patients with suspected GER. However, the efficacy of the upright position in relieving GER and reflux-related respiratory symptoms in infants is unclear. We conducted this study to investigate the efficacy of the upright position on GER and reflux-related respiratory symptoms in infants with chronic respiratory symptoms. Thirty-two infants (21 male; median age, 5 months; range, 0 to 19 months) with unexplained chronic respiratory symptoms underwent multi-channel intraluminal esophageal impedance and pH monitoring. We retrospectively compared the frequencies of GER and reflux-related symptoms according to body position. A mean of 3.30 episodes of reflux per hour was detected. Overall, refluxes were more frequent during the postprandial period than the emptying period (3.77 vs. 2.79 episodes/hour, respectively; P=0.01). Although there was no significant difference in the total refluxes per hour between the upright and recumbent positions (6.12 vs. 3.77 episodes, P=0.10), reflux-related respiratory symptoms per reflux were significantly fewer in infants kept in an upright position than in a recumbent position during the postprandial period (3.07% vs. 14.75%, P=0.016). Non-acid reflux was the predominant type of reflux in infants, regardless of body position or meal time. The upright position may reduce reflux-related respiratory symptoms, rather than reflux frequency. Thus, it may be a useful non-pharmacological treatment for infantile GER disease resistant to acid suppressants.

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

    Smith, T A; Smith, P W

    1998-07-01

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

  14. Respiratory symptoms and lung function in relation to wood dust and monoterpene exposure in the wood pellet industry.

    Löfstedt, Håkan; Hagström, Katja; Bryngelsson, Ing-Liss; Holmström, Mats; Rask-Andersen, Anna

    2017-06-01

    Wood pellets are used as a source of renewable energy for heating purposes. Common exposures are wood dust and monoterpenes, which are known to be hazardous for the airways. The purpose of this study was to study the effect of occupational exposure on respiratory health in wood pellet workers. Thirty-nine men working with wood pellet production at six plants were investigated with a questionnaire, medical examination, allergy screening, spirometry, and nasal peak expiratory flow (nasal PEF). Exposure to wood dust and monoterpenes was measured. The wood pellet workers reported a higher frequency of nasal symptoms, dry cough, and asthma medication compared to controls from the general population. There were no differences in nasal PEF between work and leisure time. A lower lung function than expected (vital capacity [VC], 95%; forced vital capacity in 1 second [FEV 1 ], 96% of predicted) was noted, but no changes were noted during shifts. There was no correlation between lung function and years working in pellet production. Personal measurements of wood dust at work showed high concentrations (0.16-19 mg/m 3 ), and exposure peaks when performing certain work tasks. Levels of monoterpenes were low (0.64-28 mg/m 3 ). There was no association between exposure and acute lung function effects. In this study of wood pellet workers, high levels of wood dust were observed, and that may have influenced the airways negatively as the study group reported upper airway symptoms and dry cough more frequently than expected. The wood pellet workers had both a lower VC and FEV 1 than expected. No cross-shift changes were found.

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

    Hersoug, Lars-Georg; Brasch-Andersen, Charlotte; Husemoen, Lise Lotte Nystrup; Sigsgaard, Torben; Linneberg, Allan

    2012-07-01

    Exposure to particulate matter (PM) may induce inflammation and oxidative stress in the airways. Carriers of null polymorphisms of glutathione S-transferases (GSTs), which detoxify reactive oxygen species, may be particularly susceptible to the effects of PM. To investigate whether deletions of GSTM1 and GSTT1 modify the potential effects of exposure to indoor sources of PM on symptoms and objective markers of respiratory disease. We conducted a population-based, cross-sectional study of 3471 persons aged 18-69 years. Information about exposure to indoor sources of PM and respiratory symptoms was obtained by a self-administered questionnaire. In addition, measurements of lung function (spirometry) and fractional exhaled nitric oxide were performed. Copy number variation of GSTM1 and GSTT1 was determined by polymerase chain reaction-based assays. We found that none of the symptoms and objective markers of respiratory disease were significantly associated with the GST null polymorphisms. An increasing number of positive alleles of the GSTM1 polymorphism tended to be associated lower prevalence of wheeze, cough, and high forced expiratory volume in 1 s (FEV(1) ), but these trends were not statistically significant. Furthermore, we did not observe any statistically significant interactions between GST copy number variation and exposure to indoor sources of PM in relation to respiratory symptoms and markers. In this adult population, GST copy number variations were not significantly associated with respiratory outcomes and did not modify the effects of self-reported exposure to indoor sources of PM on respiratory outcomes. © 2011 Blackwell Publishing Ltd.

  16. Exposure to household air pollution from wood combustion and association with respiratory symptoms and lung function in nonsmoking women: results from the RESPIRE trial, Guatemala.

    Pope, Daniel; Diaz, Esperanza; Smith-Sivertsen, Tone; Lie, Rolv T; Bakke, Per; Balmes, John R; Smith, Kirk R; Bruce, Nigel G

    2015-04-01

    With 40% of the world's population relying on solid fuel, household air pollution (HAP) represents a major preventable risk factor for COPD (chronic obstructive pulmonary disease). Meta-analyses have confirmed this relationship; however, constituent studies are observational, with virtually none measuring exposure directly. We estimated associations between HAP exposure and respiratory symptoms and lung function in young, nonsmoking women in rural Guatemala, using measured carbon monoxide (CO) concentrations in exhaled breath and personal air to assess exposure. The Randomized Exposure Study of Pollution Indoors and Respiratory Effects (RESPIRE) Guatemala study was a trial comparing respiratory outcomes among 504 women using improved chimney stoves versus traditional cookstoves. The present analysis included 456 women with data from postintervention surveys including interviews at 6, 12, and 18 months (respiratory symptoms) and spirometry and CO (ppm) in exhaled breath measurements. Personal CO was measured using passive diffusion tubes at variable times during the study. Associations between CO concentrations and respiratory health were estimated using random intercept regression models. Respiratory symptoms (cough, phlegm, wheeze, or chest tightness) during the previous 6 months were positively associated with breath CO measured at the same time of symptom reporting and with average personal CO concentrations during the follow-up period. CO in exhaled breath at the same time as spirometry was associated with lower lung function [average reduction in FEV1 (forced expiratory volume in 1 sec) for a 10% increase in CO was 3.33 mL (95% CI: -0.86, -5.81)]. Lung function measures were not significantly associated with average postintervention personal CO concentrations. Our results provide further support for the effects of HAP exposures on airway inflammation. Further longitudinal research modeling continuous exposure to particulate matter against lung function will

  17. Asthma and respiratory symptoms in hospital workers related to dampness and biological contaminants.

    Cox-Ganser, J M; Rao, C Y; Park, J-H; Schumpert, J C; Kreiss, K

    2009-08-01

    The National Institute for Occupational Safety and Health investigated respiratory symptoms and asthma in relation to damp indoor environments in employees of two hospitals. A cluster of six work-related asthma cases from one hospital department, whose symptoms arose during a time of significant water incursions, led us to conduct a survey of respiratory health in 1171/1834 employees working in the sentinel cases hospital and a nearby hospital without known indoor environmental concerns. We carried out observational assessment of dampness, air, chair, and floor dust sampling for biological contaminants, and investigation of exposure-response associations for about 500 participants. Many participants with post-hire onset asthma reported diagnosis dates in a period of water incursions and renovations. Post-hire asthma and work-related lower respiratory symptoms were positively associated with the dampness score. Work-related lower respiratory symptoms showed monotonically increasing odds ratios with ergosterol, a marker of fungal biomass. Other fungal and bacterial indices, particle counts, cat allergen and latex allergen were associated with respiratory symptoms. Our data imply new-onset of asthma in relation to water damage, and indicate that work-related respiratory symptoms in hospital workers may be associated with diverse biological contaminants. In healthcare facilities with indoor dampness and microbial contamination, possible associations between such conditions and respiratory health effects should be considered. Good building maintenance and housekeeping procedures should lead to improvements in employee respiratory health.

  18. ASSOCIATION OF PARTICULATE MATTER (PM WITH RESPIRATORY SYMPTOMS AMONG CHILDREN IN SELECTED PRIMARY SCHOOLS IN PAHANG

    Maryam

    2018-01-01

    Full Text Available Particulate matter (PM is one of the primary pollutants found in the indoor environment. It can cause deterioration of the indoor air quality (IAQ and is often linked with adverse health effects especially towards susceptible subgroup of the population like children. School children are exposed to PM inside the classroom, as this indoor PM may originate from both indoor and outdoor sources. Furthermore, ambient surrounding could be one of the major factors that contribute to its high concentration, specifically for school environment like government-subsidized schools in Malaysia whereby the schools are using natural ventilation systems to control the thermal comfort inside the classrooms. Hence the infiltration of outdoor PM into the indoor is probably high and significant. The high concentration of PM may affect the children’s health and learning performances. Due to this reason, it is important to study the effects of PM towards children. Thus, this study aims to assess the concentrations of PM and selected IAQ parameters in the school indoor environment with distinct background characteristics including residential, industrial, and rural areas. PM and IAQ parameters (temperature, relative humidity (RH, carbon monoxide (CO and carbon dioxide (CO2 were assessed for 8-hours duration via DustMate Environmental Dust Detector (Turnkey Instruments, USA and VelociCalc® Multi-Function Ventilation Meter 9565 (TSI®, USA respectively, during occupied and non-occupied time in the classrooms. Second, considering the children’s prolonged and repetitive exposure towards PM in school indoor environment and their body sensitivity, this study also screened for the prevalence of non-specific respiratory disease (NSRD and persistent cough and phlegm (PCP among children via structured questionnaire developed by American Thoracic Society’s Division of Lung Diseases (ATS-DLD-78-C. Higher concentrations of PM and prevalence of respiratory symptoms in the

  19. Prevalence of COPD and respiratory symptoms associated with biomass smoke exposure in a suburban area

    Ramírez-Venegas A

    2018-05-01

    Full Text Available Alejandra Ramírez-Venegas,1 Mónica Velázquez-Uncal,1 Rosaura Pérez-Hernández,2 Nicolás Eduardo Guzmán-Bouilloud,1 Ramcés Falfán-Valencia,3 María Eugenia Mayar-Maya,4 Adrian Aranda-Chávez,1 Raúl H Sansores5 1Tobacco Smoking and COPD Research Department, Instituto Nacional de Enfermedades Respiratorias Ismael Cosio Villegas, Mexico City, Mexico; 2Research Department of Tobacco Smoking, Centro de Investigacion de Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, Mexico; 3HLA Laboratory, Instituto Nacional de Enfermedades Respiratorias Ismael Cosio Villegas, Mexico City, Mexico; 4Medical Attention Department, Instituto Nacional de Enfermedades Respiratorias Ismael Cosio Villegas, Mexico City, Mexico; 5Medica Sur Clinic & Foundation, Mexico City, Mexico Introduction: Biomass smoke exposure (BSE is a recognized cause of COPD particularly in rural areas. However, little research has been focused on BSE in suburban areas. Objective: The aim of this study was to determine the prevalence of COPD, respiratory symptoms (RS and BSE in women living in a suburban area of Mexico City exposed to BSE. Methods: A cross-sectional epidemiological survey of a female population aged >35 years was performed using a multistage cluster sampling strategy. The participants completed questionnaires on RS and COPD risk factors. The COPD prevalence was based on the postbronchodilator forced expiratory volume in the first second (FEV1/forced vital capacity (FVC ratio. Of the 1,333 women who completed the respiratory questionnaires, spirometry data were obtained from 1,190, and 969 of these were scored as A–C. Results: The prevalence of BSE was 47%, and the estimated prevalence of COPD was 2.5% for the total population (n=969 and 3.1% for those with BSE only. The spirometry and oximetry values were significantly lower in women with greater exposure levels. The prevalence of RS (cough, phlegm, wheezing and dyspnea was significantly higher in the

  20. Chronic dry cough: Diagnostic and management approaches

    Ashok Mahashur

    2015-01-01

    Full Text Available Cough is the most common symptom for which medical treatment is sought in the outpatient setting. Chronic dry cough poses a great diagnostic and management challenge due to myriad etiologies. Chronic cough has been commonly considered to be caused by gastroesophageal reflux, post-nasal drip or asthma. However, recent evidences suggest that many patients with these conditions do not have cough, and in those with cough, the response to specific treatments is unpredictable at best. This raises questions about the concept of a triad of treatable causes for chronic cough. This article discusses the mechanism and etiology of cough, along with recent advances in the field of cough, highlighting some of the diagnostic and management challenges.

  1. Traffic-related air pollution and respiratory symptoms among asthmatic children, resident in Mexico City: the EVA cohort study

    Cortez-Lugo Marlene

    2008-11-01

    Full Text Available Abstract Background Taffic-related air pollution has been related to adverse respiratory outcomes; however, there is still uncertainty concerning the type of vehicle emission causing most deleterious effects. Methods A panel study was conducted among 147 asthmatic and 50 healthy children, who were followed up for an average of 22 weeks. Incidence density of coughing, wheezing and breathing difficulty was assessed by referring to daily records of symptoms and child's medication. The association between exposure to pollutants and occurrence of symptoms was evaluated using mixed-effect models with binary response and poisson regression. Results Wheezing was found to relate significantly to air pollutants: an increase of 17.4 μg/m3 (IQR of PM2.5 (24-h average was associated with an 8.8% increase (95% CI: 2.4% to 15.5%; an increase of 34 ppb (IQR of NO2 (1-h maximum was associated with an 9.1% increase (95% CI: 2.3% to16.4% and an increase of 48 ppb (IQR in O3 levels (1 hr maximum to an increase of 10% (95% CI: 3.2% to 17.3%. Diesel-fueled motor vehicles were significantly associated with wheezing and bronchodilator use (IRR = 1.29; 95% CI: 1.03 to 1.62, and IRR = 1.32; 95% CI: 0.99 to 1.77, respectively, for an increase of 130 vehicles hourly, above the 24-hour average. Conclusion Respiratory symptoms in asthmatic children were significantly associated with exposure to traffic exhaust, especially from natural gas and diesel-fueled vehicles.

  2. Persistent cough in an adolescent.

    Stein, M T; Harper, G; Chen, J

    1999-12-01

    Jessica, a 14-year-old girl with a history of asthma, went to her pediatrician's office because of a persistent cough. She had been coughing for at least 3 months with occasional cough-free periods of less than a few days. The cough was nonproductive and was not accompanied by fever, rhinorrhea, or facial or chest pain. Jessica and her mother observed that the cough increased with exercise and typically was not present during sleep. She has used two metered-dose inhalers--albuterol and cromolyn--without any change in the cough pattern. For the past 5 years, Jessica has had mild asthma responsive to albuterol. She enjoys running on the cross-country team, soccer, and dancing. She is an average student and denies any change in academic performance. She has never been hospitalized or had an emergency department visit for asthma or pneumonia. There has been no recent travel or exposure to a person with a chronic productive cough, tobacco smoke, or a live-in pet. Jessica lives with her mother and younger sister in a 10-year-old, carpeted apartment without any evidence of mold or recent renovation. In the process of taking the history, the pediatrician noticed that Jessica coughed intermittently, with two or three coughs during each episode. At times, the cough was harsh; at other times, it was a quiet cough, as if she were clearing her throat. She was cooperative, without overt anxiety or respiratory distress. After a complete physical examination with normal findings, the pediatrician interviewed Jessica and her mother alone. Jessica's parents had been divorced for the past 6 years. She lived with her mother but visited her father, and his new family with two young children, every weekend. She spoke about this arrangement comfortably and said that she loved her father and mother but didn't like the tension she experienced at her father's home. "I don't like adults arguing when kids are around." When asked why she thought the cough persisted so long, she commented in a

  3. Association of interleukin-8 and neutrophils with nasal symptom severity during acute respiratory infection.

    Henriquez, Kelsey M; Hayney, Mary S; Xie, Yaoguo; Zhang, Zhengjun; Barrett, Bruce

    2015-02-01

    Using a large data set (n = 811), the relationship between acute respiratory infection illness severity and inflammatory biomarkers was investigated to determine whether certain symptoms are correlated more closely than others with the inflammatory biomarkers, interleukin-8 (IL-8) and nasal neutrophils. Participants with community acquired acute respiratory infection underwent nasal lavage for IL-8 and neutrophil testing, in addition to multiplex polymerase chain reaction (PCR) methods for the detection and identification of respiratory viruses. Information about symptoms was obtained throughout the duration of the illness episode using the well-validated Wisconsin Upper Respiratory Symptom Survey (WURSS-21). Global symptom severity was calculated by the area under the curve (AUC) plotting duration versus WURSS total. Of the specimens tested, 56% were positively identified for one or more of nine different respiratory viruses. During acute respiratory infection illness, both IL-8 and neutrophils positively correlate with AUC (r(s) = 0.082, P = 0.022; r(s)  = 0.080, P = 0.030). IL-8 and neutrophils correlate with nasal symptom severity: runny nose (r = 0.13, P = acute respiratory infection. Further research is necessary to determine if the concentration of these or other biomarkers can predict the overall duration and severity of acute respiratory infection illness. © 2014 Wiley Periodicals, Inc.

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

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

    2012-01-01

    Introduction: Exposure to particulate matter (PM) may induce inflammation and oxidative stress in the airways. Carriers of null polymorphisms of glutathione S-transferases (GSTs), which detoxify reactive oxygen species, may be particularly susceptible to the effects of PM. Objectives: To investig....... The relationship of glutathione-S-transferases copy number variation and indoor air pollution to symptoms and markers of respiratory disease. Clin Respir J 2011; DOI:10.1111/j.1752-699X.2011.00258.x.......: To investigate whether deletions of GSTM1 and GSTT1 modify the potential effects of exposure to indoor sources of PM on symptoms and objective markers of respiratory disease. Methods: We conducted a population-based, cross-sectional study of 3471 persons aged 18-69 years. Information about exposure to indoor......: We found that none of the symptoms and objective markers of respiratory disease were significantly associated with the GST null polymorphisms. An increasing number of positive alleles of the GSTM1 polymorphism tended to be associated lower prevalence of wheeze, cough, and high forced expiratory...

  5. Role of non-acid gastro-esophageal reflux in children with respiratory symptoms.

    Zenzeri, Letizia; Quitadamo, Paolo; Tambucci, Renato; Ummarino, Dario; Poziello, Antonio; Miele, Erasmo; Staiano, Annamaria

    2017-05-01

    Respiratory symptoms are a possible atypical clinical picture of gastro-esophageal reflux disease (GERD). However, a significant number of patients with GERD-related respiratory symptoms do not report improvement despite aggressive acid-suppressive therapy. Some of these refractory cases may be due to the recently appreciated entity of non-acid or weakly acidic reflux. The aim of our study is to assess the pH-impedance features of GER inducing airway symptoms, compared with GER inducing typical gastro-intestinal (GI) symptoms. We prospectively enrolled infants and children with GERD-related respiratory symptoms from January 2015 to December 2015. Age- and sex-matched patients with GERD-related GI symptoms were enrolled as comparison group. The overall number, the acidity pattern, and the height of reflux episodes were compared between the two groups. Forty patients (M/F: 20/20; mean age: 58.3 months) were enrolled in the study group and 40 in the comparison group. The mean acid exposure index was 7.9% within the study group and 15.9% within the comparison group (p:0.026). Children with respiratory symptoms versus children with GI symptoms had a mean of 40.8 acid reflux episodes versus 62.4 (p:0.001), a mean of 2.2 weakly acid reflux episodes versus 20.1 (p:0.002), and a mean of 22.1 weakly alkaline reflux episodes versus 10.2 (P 1 year with GERD-related respiratory symptoms showed a significantly higher number of weakly alkaline refluxes than children with GERD-related GI symptoms. This supports the hypothesis that respiratory symptoms are less related to acidity than GI symptoms. Pediatr Pulmonol. 2017;52:669-674. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

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

    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...

  7. Building-related risk factors and work-related lower respiratory symptoms in 80 office buildings

    Mendell, M.J.; Naco, G.M.; Wilcox, T.G.; Sieber, W.K.

    2002-01-01

    We assessed building-related risk factors for lower respiratory symptoms in office workers. The National Institute for Occupational Safety and Health in 1993 collected data during indoor environmental health investigations of workplaces. We used multivariate logistic regression analyses to assess relationships between lower respiratory symptoms in office workers and risk factors plausibly related to microbiologic contamination. Among 2,435 occupants in 80 office buildings, frequent, work-related multiple lower respiratory symptoms were strongly associated, in multivariate models, with two risk factors for microbiologic contamination: poor pan drainage under cooling coils and debris in outside air intake. Associations tended to be stronger among those with a history of physician-diagnosed asthma. These findings suggest that adverse lower respiratory health effects from indoor work environments, although unusual, may occur in relation to poorly designed or maintained ventilation systems, particularly among previously diagnosed asthmatics. These findings require confirmation in more representative buildings.

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

    Laursen, C. B.

    2015-01-01

    In patients admitted with respiratory failure, a large proportion is diagnosed incorrectly in the emergency department and an even larger proportion seems to receive inappropriate treatment. Inappropriate initial treatment of these patients in the emergency department is associated with increased...... triage, patients with cardiac arrest, patients with undifferentiated shock, patients with cardiopulmonary instability, patients with respiratory symptoms, trauma patients with suspected cardiac injuries, and assessment of the fluid status before fluid loading. When using focused cardiac ultrasound (US......) in patients with respiratory symptoms, the typical objectives would be to identify pericardial effusion and enlargement of cardiac cavities, to estimate global systolic left-ventricular function, and to assess the volume status. The routine use of focused cardiac US in patients with respiratory symptoms may...

  9. Respiratory symptoms are more common among short sleepers independent of obesity

    Björnsdóttir, Erla; Janson, Christer; Lindberg, Eva

    2017-01-01

    , marital status, exercise and smoking. Excluding BMI from the model covariates did not affect the results. Short sleep was related to 11 out of 16 respiratory and nasal symptoms among subjects with BMI ≥30 and 9 out of 16 symptoms among subjects with BMI sleep......INTRODUCTION: Sleep length has been associated with obesity and various adverse health outcomes. The possible association of sleep length and respiratory symptoms has not been previously described. The aim of this study was to investigate the association between sleep length and respiratory...... Health Survey III. The mean±SD age was 54.2±7.1 (age range 39-67 years). Information was collected on general and respiratory health and sleep characteristics. RESULTS: The mean reported nighttime sleep duration was 6.9±1.0 hours. Short sleepers (

  10. Building-related risk factors and work-related lower respiratory symptoms in 80 office buildings

    Mendell, M.J.; Naco, G.M.; Wilcox, T.G.; Sieber, W.K.

    2002-01-01

    We assessed building-related risk factors for lower respiratory symptoms in office workers. The National Institute for Occupational Safety and Health in 1993 collected data during indoor environmental health investigations of workplaces. We used multivariate logistic regression analyses to assess relationships between lower respiratory symptoms in office workers and risk factors plausibly related to microbiologic contamination. Among 2,435 occupants in 80 office buildings, frequent, work-related multiple lower respiratory symptoms were strongly associated, in multivariate models, with two risk factors for microbiologic contamination: poor pan drainage under cooling coils and debris in outside air intake. Associations tended to be stronger among those with a history of physician-diagnosed asthma. These findings suggest that adverse lower respiratory health effects from indoor work environments, although unusual, may occur in relation to poorly designed or maintained ventilation systems, particularly among previously diagnosed asthmatics. These findings require confirmation in more representative buildings

  11. The Incidence and Short-term Outcomes of Acute Respiratory Illness with Cough in Children from a Socioeconomically Disadvantaged Urban Community in Australia: A Community-Based Prospective Cohort Study

    Kerry K. Hall

    2017-10-01

    Full Text Available BackgroundAcute respiratory illnesses with cough (ARIwC are predominant causes of morbidity in Australian Indigenous children; however, data on disease burden in urban communities are scarce. This study aimed to determine the incidence of ARIwC, the predictors of recurrent (≥4 episodes ARIwC, and development of chronic cough following an ARIwC in urban, predominantly Indigenous, children aged <5 years from northern Brisbane, Australia.MethodsProspective cohort study of children aged <5 years registered with a primary healthcare center. ARIwC episodes and outcomes were collected for 12 months. Recurrent ARIwC was defined as ≥4 episodes in 12 months. Chronic cough was defined as cough lasting >4 weeks. Children who developed chronic cough were reviewed by a pediatric pulmonologist. Incidence densities per child-month of observation were calculated and predictors of recurrent ARIwC and chronic cough were evaluated in logistic regression models.ResultsBetween February 2013 and November 2015, 200 children were enrolled; median age of 18.1 months, range (0.7–59.7 months and 90% identified as Indigenous. A total of 1,722 child-months of observation were analyzed (mean/child = 8.58, 95% CI 8.18–9.0. The incidence of ARIwC was 24.8/100 child-months at risk (95% CI 22.3–27.5. Twenty-one children (10.5% experienced recurrent ARIwC. Chronic cough was identified in 70/272 (25.7% episodes of ARIwC. Predictors of recurrent ARIwC were presence of eczema, mold in the house, parent/carer employment status, and having an Aboriginal and Torres Strait Islander mother/non-Aboriginal and Torres Strait Islander father (compared to both parents being Aboriginal and Torres Strait Islander. Predictors of chronic cough included being aged <12 months, eczema, childcare attendance, previous history of cough of >4 weeks duration, having an Aboriginal and Torres Strait Islander mother/non-Aboriginal and Torres Strait Islander father (compared to

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

    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.

  13. Effects of exposure to flour dust on respiratory symptoms and pulmonary function of mill workers

    Hamdy A. Mohammadien

    2013-10-01

    Conclusion: Flour mill workers in Sohag Governorate, like grain workers elsewhere, were at an increased risk of developing pulmonary symptoms, a strong association exists between exposure to flour dust and the prevalence of respiratory symptoms and functional impairments of the lungs. The result has implications for improved dust control measures in the grain industry in Egypt.

  14. Isocyanate exposure and respiratory symptoms in Dutch car spray painters

    Heederik, D.; Pronk, A.; Doekes, G.; Bobbeldijk, I.; Preller, L.

    2005-01-01

    Isocyanate allergy and asthma is an important respiratory disease in most industrialized countries. Little information about its importance is available for the Netherlands. A baseline survey, part of a larger longitudinal epidemiological survey, shows that exposure to mainly HDI monomers and

  15. Respiratory symptoms and lung function impairment in underground ...

    Background: This is the first study in Ghana in the Obuasi gold mines where the silica content of the respirable dust is 10%, less than in previously studied gold mines, with only 23% of the miners having ever smoked. Objectives: The study was to assess the prevalence of respiratory impairment in the Ghanaian gold miner ...

  16. Management of Cough: a practical approach | Vally | South African ...

    On a regular day, healthcare providers will be contacted by one or more health seekers presenting with cough as a symptom. Cough has been considered an important physiological reflex that protects the airways from aspiration of foreign materials. Cough is one of the most common symptoms for which people seek ...

  17. Cough during infancy and subsequent childhood asthma.

    Oren, E; Rothers, J; Stern, D A; Morgan, W J; Halonen, M; Wright, A L

    2015-09-01

    Wheezing in infancy has been associated with subsequent asthma, but whether cough similarly influences asthma risk has been little studied. We sought to determine whether prolonged cough and cough without cold in the first year of life are associated with childhood asthma. Participants in the Infant Immune Study, a non-selected birth cohort, were surveyed 7 times in the first 9 months of life regarding the presence of wheeze and cough. Cough for more than 28 days was defined as prolonged. Parents were asked at 1 year if the child ever coughed without a cold. Asthma was defined as parental report of physician diagnosis of asthma, with symptoms or medication use between 2 and 9 years. Logistic regression was used to assess adjusted odds for asthma associated with cough characteristics. A total of 24% (97) of children experienced prolonged cough and 23% (95) cough without cold in the first 9 months, respectively. Prolonged cough was associated with increased risk of asthma relative to brief cough (OR 3.57, CI: 1.88, 6.76), with the risk being particularly high among children of asthmatic mothers. Cough without cold (OR 3.13, 95% CI: 1.76, 5.57) was also independently associated with risk of childhood asthma. Both relations persisted after adjustment for wheeze and total IgE at age 1. Prolonged cough in infancy and cough without cold are associated with childhood asthma, independent of infant wheeze. These findings suggest that characteristics of cough in infancy are early markers of asthma susceptibility, particularly among children with maternal asthma. © 2015 John Wiley & Sons Ltd.

  18. Cough & Cold Medicine Abuse

    ... Videos for Educators Search English Español Cough & Cold Medicine Abuse KidsHealth / For Teens / Cough & Cold Medicine Abuse ... resfriado Why Do People Use Cough and Cold Medicines to Get High? There's an ingredient in many ...

  19. Pertussis (Whooping Cough)

    ... guidelines, articles... Pregnant? Help Protect Your Baby from Whooping Cough frame support disabled and/or not supported in ... the disease. Also available on YouTube. Pregnancy and Whooping Cough Learn more about whooping cough vaccination during pregnancy… ...

  20. Risk factors for persistence of lower respiratory symptoms among community members exposed to the 2001 World Trade Center terrorist attacks

    Jordan, Hannah T; Friedman, Stephen M; Reibman, Joan; Goldring, Roberta M; Miller Archie, Sara A; Ortega, Felix; Alper, Howard; Shao, Yongzhao; Maslow, Carey B; Cone, James E; Farfel, Mark R; Berger, Kenneth I

    2017-01-01

    Objectives We studied the course of lower respiratory symptoms (LRS; cough, wheeze or dyspnoea) among community members exposed to the 9/11/2001 World Trade Center (WTC) attacks during a period of 12–13 years following the attacks, and evaluated risk factors for LRS persistence, including peripheral airway dysfunction and post-traumatic stress disorder (PTSD). Methods Non-smoking adult participants in a case-control study of post-9/11-onset LRS (exam 1, 2008–2010) were recruited for follow-up (exam 2, 2013–2014). Peripheral airway function was assessed with impulse oscillometry measures of R5 and R5-20. Probable PTSD was a PTSD checklist score ≥44 on a 2006–2007 questionnaire. Results Of 785 exam 1 participants, 545 (69%) completed exam 2. Most (321, 59%) were asymptomatic at all assessments. Among 192 participants with initial LRS, symptoms resolved for 110 (57%) by exam 2, 55 (29%) had persistent LRS and 27 (14%) had other patterns. The proportion with normal spirometry increased from 65% at exam 1 to 85% at exam 2 in the persistent LRS group (p<0.01) and was stable among asymptomatic participants and those with resolved LRS. By exam 2, spirometry results did not differ across symptom groups; however, R5 and R5-20 abnormalities were more common among participants with persistent LRS (56% and 46%, respectively) than among participants with resolved LRS (30%, p<0.01; 27%, p=0.03) or asymptomatic participants (20%, p<0.001; 8.2%, p<0.001). PTSD, R5 at exam 1, and R5-20 at exam 1 were each independently associated with persistent LRS. Conclusions Peripheral airway dysfunction and PTSD may contribute to LRS persistence. Assessment of peripheral airway function detected pulmonary damage not evident on spirometry. Mental and physical healthcare for survivors of complex environmental disasters should be coordinated carefully. PMID:28341697

  1. Oxidative stress and respiratory symptoms due to human exposure to polycyclic aromatic hydrocarbons (PAHs) in Kumasi, Ghana

    Bortey-Sam, Nesta; Ikenaka, Yoshinori; Akoto, Osei; Nakayama, Shouta M.M.; Asante, Kwadwo A.; Baidoo, Elvis; Obirikorang, Christian; Saengtienchai, Aksorn; Isoda, Norikazu; Nimako, Collins

    2017-01-01

    Studies of polycyclic aromatic hydrocarbons (PAHs) and its metabolites in PM10, soils, rat livers and cattle urine in Kumasi, Ghana, revealed high concentrations and cancer potency. In addition, WHO and IARC have reported an increase in cancer incidence and respiratory diseases in Ghana. Human urine were therefore collected from urban and control sites to: assess the health effects associated with PAHs exposure using malondialdehyde (MDA) and 8-hydroxy-2-deoxyguanosine (8-OHdG); identify any association between OH-PAHs, MDA, 8-OHdG with age and sex; and determine the relationship between PAHs exposure and occurrence of respiratory diseases. From the results, urinary concentrations of the sum of OH-PAHs (∑OHPAHs) were significantly higher from urban sites compared to the control site. Geometric mean concentrations adjusted by specific gravity, GM SG , indicated 2-OHNaphthalene (2-OHNap) (6.01 ± 4.21 ng/mL) as the most abundant OH-PAH, and exposure could be through the use of naphthalene-containing-mothballs in drinking water purification, insect repellent, freshener in clothes and/or “treatment of various ailments”. The study revealed that exposure to naphthalene significantly increases the occurrence of persistent cough (OR = 2.68, CI: 1.43–5.05), persistent headache (OR = 1.82, CI: 1.02–3.26), tachycardia (OR = 3.36, CI: 1.39–8.10) and dyspnea (OR = 3.07, CI: 1.27–7.43) in Kumasi residents. Highest level of urinary 2-OHNap (224 ng/mL) was detected in a female, who reported symptoms of persistent cough, headache, tachycardia, nasal congestion and inflammation, all of which are symptoms of naphthalene exposure according to USEPA. The ∑OHPAHs, 2-OHNap, 2-3-OHFluorenes, and -OHPhenanthrenes showed a significantly positive correlation with MDA and 4-OHPhenanthrene with 8-OHdG, indicating possible lipid peroxidation/cell damage or degenerative disease in some participants. MDA and 8-OHdG were highest in age group 21–60. The present study

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

    Kochen Michael M

    2005-02-01

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

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

    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.

  4. Respiratory Symptoms and Lung Function in Poultry Confinement Workers in Western Canada

    Kirychuk, Shelley P; Senthilselvan, Ambikaipakan; Dosman, James A; Juorio, Victor; Feddes, John JR; Willson, Philip; Classen, Henry; Reynolds, Stephen J; Guenter, Wilhelm; Hurst, Thomas S

    2003-01-01

    OBJECTIVE: To determine whether poultry production methods impact respiratory health, and whether poultry farmers have more respiratory symptoms and lower lung function than comparison control groups.DESIGN: Cross-sectional study.SETTING: Provinces of Saskatchewan, Alberta and Manitoba during the winters of 1997 to 1999. POPULATION: Three hundred three poultry workers, 241 grain farmers and 206 nonfarming control subjects were studied. Poultry workers were further classified according to the ...

  5. Medicine use practices in management of symptoms of acute upper respiratory tract infections in children (≤12 years in Kampala city, Uganda

    Moses Ocan

    2017-09-01

    Full Text Available Abstract Background Medicines are commonly accessed and used for management of illness in children without a prescription. This potentially increases the risk of unwanted treatment outcomes. We investigated medicine use practices in management of symptoms of acute upper respiratory tract infections among children (≤12 years in households in Nakawa division, Kampala city. Methods This was a cross-sectional study conducted among 390 randomly selected children. Data on use of medicines in children (≤12 years during recent episode of acute upper respiratory tract infection was collected from their care takers using an interviewer administered questionnaire. A recall period of two weeks (14 days was used in during data collection. Results The prevalence of giving children non-prescription antimicrobial medicines was 44.8% (38.3-52.2. The most common disease symptoms that the children reportedly had included flu, 84.9% (331/390, cough, 83.1% (324/390, and undefined fever, 69.7% (272/390. Medicines commonly given to children included, paracetamol 53.1% (207/390, Coartem 29.7% (116/390, cough linctus 20.8% (81/390, amoxicillin 18.9% (74/390, Co-trimoxazole 18.5% (72/390, and diphenhydramine 15.4% (60/390. The major sources of medicines given to the children was hospital/clinic, 57.26% (223/390. Most of the children, 81% were given more than one medicine at a time. The majority, 62.3% (243/390 of the care takers who gave the children medicine during the recent illness were not aware of any medicine (s that should not be given to children. The predictors of non-prescription use of antimicrobial medicines in managing symptoms of acute upper respiratory tract infections in children included, medicines obtained from drug shop (PR: 1.45, CI: 1.14-1.85, medicines at home (PR: 1.8, CI: 0.83-1.198 and type of medicine (antimalarial (PR: 2.8, CI: 1.17-6.68. Conclusion Children are commonly given multiple medicines during episodes of acute upper respiratory

  6. Medicine use practices in management of symptoms of acute upper respiratory tract infections in children (≤12 years) in Kampala city, Uganda.

    Ocan, Moses; Aono, Mary; Bukirwa, Clare; Luyinda, Emmanuel; Ochwo, Cathy; Nsambu, Elastus; Namugonza, Stella; Makoba, Joseph; Kandaruku, Enock; Muyende, Hannington; Nakawunde, Aida

    2017-09-21

    Medicines are commonly accessed and used for management of illness in children without a prescription. This potentially increases the risk of unwanted treatment outcomes. We investigated medicine use practices in management of symptoms of acute upper respiratory tract infections among children (≤12 years) in households in Nakawa division, Kampala city. This was a cross-sectional study conducted among 390 randomly selected children. Data on use of medicines in children (≤12 years) during recent episode of acute upper respiratory tract infection was collected from their care takers using an interviewer administered questionnaire. A recall period of two weeks (14 days) was used in during data collection. The prevalence of giving children non-prescription antimicrobial medicines was 44.8% (38.3-52.2). The most common disease symptoms that the children reportedly had included flu, 84.9% (331/390), cough, 83.1% (324/390), and undefined fever, 69.7% (272/390). Medicines commonly given to children included, paracetamol 53.1% (207/390), Coartem 29.7% (116/390), cough linctus 20.8% (81/390), amoxicillin 18.9% (74/390), Co-trimoxazole 18.5% (72/390), and diphenhydramine 15.4% (60/390). The major sources of medicines given to the children was hospital/clinic, 57.26% (223/390). Most of the children, 81% were given more than one medicine at a time. The majority, 62.3% (243/390) of the care takers who gave the children medicine during the recent illness were not aware of any medicine (s) that should not be given to children. The predictors of non-prescription use of antimicrobial medicines in managing symptoms of acute upper respiratory tract infections in children included, medicines obtained from drug shop (PR: 1.45, CI: 1.14-1.85), medicines at home (PR: 1.8, CI: 0.83-1.198) and type of medicine (antimalarial) (PR: 2.8, CI: 1.17-6.68). Children are commonly given multiple medicines during episodes of acute upper respiratory tract infections with most antimicrobial

  7. Modelling of coughed droplets in a hospital ward

    Sadrizadeh, Sasan; Nielsen, Peter Vilhelm

    2016-01-01

    Coughing and its importance for spreading respiratory infectious diseases has been confirmed in many previous studies. The dispersion process of respiratory droplets released by the coughing of a patient in a hospital ward was studied using computational fluid dynamics simulation. Two relatively ...

  8. Respiratory symptoms and ventilatory function of the Bakery worker ...

    Peak expiratory flow rate (PEFR) was measured in all subjects. However, full spirometry work up was done on 100 bakery workers and 100 control subjects that had been selected using simple random sampling technique. The most frequent pulmonary symptoms among the bakery workers were sneezing and running nose ...

  9. Changes in respiratory and non-respiratory symptoms in occupants of a large office building over a period of moisture damage remediation attempts.

    Park, Ju-Hyeong; Cho, Sook Ja; White, Sandra K; Cox-Ganser, Jean M

    2018-01-01

    There is limited information on the natural history of building occupants' health in relation to attempts to remediate moisture damage. We examined changes in respiratory and non-respiratory symptoms in 1,175 office building occupants over seven years with multiple remediation attempts. During each of four surveys, we categorized participants using a severity score: 0 = asymptomatic; 1 = mild, symptomatic in the last 12 months, but not frequently in the last 4 weeks; 2 = severe, symptomatic at least once weekly in the last 4 weeks. Building-related symptoms were defined as improving away from the building. We used random intercept models adjusted for demographics, smoking, building tenure, and microbial exposures to estimate temporal changes in the odds of building-related symptoms or severity scores independent of the effect of microbial exposures. Trend analyses of combined mild/severe symptoms showed no changes in the odds of respiratory symptoms but significant improvement in non-respiratory symptoms over time. Separate analyses showed increases in the odds of severe respiratory symptoms (odds ratio/year = 1.15‒1.16, p-values<0.05) and severity scores (0.02/year, p-values<0.05) for wheezing and shortness of breath on exertion, due to worsening of participants in the mild symptom group. For non-respiratory symptoms, we found no changes in the odds of severe symptoms but improvement in severity scores (-0.04‒-0.01/year, p-values<0.05) and the odds for mild fever and chills, excessive fatigue, headache, and throat symptoms (0.65-0.79/year, p-values<0.05). Our study suggests that after the onset of respiratory and severe non-respiratory symptoms associated with dampness/mold, remediation efforts might not be effective in improving occupants' health.

  10. Exposure to field vs. storage wheat dust: different consequences on respiratory symptoms and immune response among grain workers.

    Barrera, Coralie; Wild, Pascal; Dorribo, Victor; Savova-Bianchi, Dessislava; Laboissière, Audrey; Pralong, Jacques A; Danuser, Brigitta; Krief, Peggy; Millon, Laurence; Reboux, Gabriel; Niculita-Hirzel, Hélène

    2018-05-26

    The aim of this study was to understand the differential acute effects of two distinct wheat-related dusts, such as field or stored wheat dust handling, on workers' health and how those effects evolved at 6 month intervals. Exposure, work-related symptoms, changes in lung function, and blood samples of 81 workers handling wheat and 61 controls were collected during the high exposure season and 6 months after. Specific IgG, IgE, and precipitins against 12 fungi isolated from wheat dust were titrated by enzyme-linked immunosorbent assay, dissociation-enhanced lanthanide fluorescence immunoassay, and electrosyneresis. The level of fungi was determined in the workers' environment. Levels of exhaled fraction of nitrogen monoxide (F E NO) and total IgE were obtained. Exposure response associations were investigated by mixed logistic and linear regression models. The recent exposure to field wheat dust was associated with a higher prevalence for five of six self-reported airway symptoms and with a lower F E NO than those in the control population. Exposure to stored wheat dust was only associated with cough. No acute impact of exposure on respiratory function was observed. Exposure to field wheat dust led to workers' sensitization against the three field fungi Aureobasidum, Cryptococcus, and Phoma, although exposure to storage wheat dust was associated with tolerance. The level of Ig remained stable 6 months after exposure. The clinical picture of workers exposed to field or storage wheat dust differed. The systematic characterization of the aerosol microbial profile may help to understand the reasons for those differences.

  11. Coughing (For Parents)

    ... usually don't prescribe antibiotics because these only work against bacteria. Unless a cough won't let your child sleep, cough medicines are not needed. They might help a child stop coughing, but they don't treat the cause of the cough. If you do use an ...

  12. Treatment of recalcitrant cough with baclofen

    Paolo Agostinis

    2013-04-01

    Full Text Available Background: Chronic dry cough is a debilitating symptom often refractory to standard antitussive therapy. It may result from increased sensitivity of the cough reflex. Baclofen, an agonist of gamma-aminobutyric acid (GABA, has been shown, in animals, to have antitussive activity via a central mechanism. In normal subjects baclofen has been revealed ability to inhibit capsaicininduced cough and cough due to angiotensin-converting enzyme (ACE inhibitors. In addition, chronic therapy with baclofen has been shown to reduce cough reflex sensitivity in subjects with cervical spinal cord injury. Clinical cases: We describe two patients with chronic refractory cough who obtained symptomatic improvement after oral baclofen administration. The antitussive effect of baclofen, usually used for treatment of spasticity associated with multiple sclerosis and spinal cord lesions, can be explained by central inhibition, but may also involve peripheral inhibitory mechanisms.

  13. Effects of Household Air Pollution in Malawi and Human Immunodeficiency Virus Status on Respiratory Symptoms and Inflammation, Injury, and Repair Markers.

    Kim, Charles; Jary, Hannah; Mortimer, Kevin; Schweitzer, Kelly S; Curran-Everett, Doug; Gordon, Stephen; Petrache, Irina

    2018-04-01

    Household air pollution (HAP) and human immunodeficiency virus (HIV) are associated with increased risk for chronic obstructive pulmonary disease. Both HAP and HIV are widespread in Sub-Saharan Africa, including Malawi, where HIV has 10.6% prevalence in patients 15-49 years old. We hypothesized that HIV infection (HIV + ) and habitual exposure to HAP (HAP + ) synergize to cause systemic inflammation and vascular injury, which may herald early onset of chronic respiratory diseases. In this pilot study, 50 subjects from Malawi with known HIV status were administered surveys recording demographics, HAP exposure, and respiratory symptoms/diagnoses. Peripheral blood was collected, and Meso Scale Discovery V-Plex assay was used to measure the levels of 41 serum markers. Almost all subjects (96%) reported HAP + , 30 were HIV + , 20 were HIV - , with a mean age of 22 years in both groups. More females (73%) were HIV + , whereas 65% of those who were HIV - were males. The vast majority were never-smokers (70% of HIV - and 83% of HIV + subjects, respectively). Forty-six percent of all subjects (57% of HIV + HAP + and 33% of HIV - HAP + ) reported respiratory diagnoses and/or respiratory symptoms, with breathlessness and cough being most common. Although HIV + HAP + individuals had a trend to increased proinflammatory cytokines and vascular injury markers, and decreases in proangiogenic factors compared with HIV - HAP + , only the decrease in serum interleukin-16 (by 44%) was statistically significant (P = 0.03). Also, compared with other subjects, serum interleukin-2 levels were significantly decreased (by 31%; P = 0.02) in HIV + subjects with persistent respiratory symptoms. This study suggests a high prevalence of respiratory symptoms in HIV + individuals exposed to HAP. The significant decrease in interleukin-2 and interleukin-16, cytokines associated with HIV clearance, may contribute to viral persistence, and because their low levels were found to correlate with

  14. Presence of specific IgG antibody to grain dust does not go with respiratory symptoms.

    Park, H S; Suh, C H; Nahm, D H; Kim, H Y

    1999-02-01

    A high prevalence of work-related symptoms in relation to grain dust exposure has been reported in grain dust workers, but the role of the specific IgG antibody is unknown. To study the possible role of specific IgG (sIgG) and specific IgG4 (sIgG4) in the development of work-related symptoms, sIgG and sIgG4 subclass antibodies against grain dust antigens were determined by ELISA in sera from 43 workers and 27 non-exposed controls. They were compared with results of specific IgE antibodies, exposure intensity and the presence of respiratory symptoms. SIgG and sIgG4 antibodies were detectable in almost all sera of exposed workers, and the prevalence were significantly higher than those of controls (pgrain dust exposure and may unlikely play a role in the etiology of respiratory symptoms.

  15. Pulmonary function tests and respiratory symptoms among smokers in the city of mashhad (north east of Iran

    M.H. Boskabady

    2011-09-01

    Full Text Available The prevalence of smoking was studied using a questionnaire. Pulmonary function tests and respiratory symptoms were evaluated in 176 smokers. The total studied population with family and co-workers were 13289. The number of smokers among studied population was 11.7%. The rate of smoking among male subjects was 17.2% and in female 2.5%. All values of PFTs in smokers were significantly lower (p < 0.001 and respiratory symptoms higher than in non smokers (p < 0.05 for cough and p < 0.001 for wheeze and tightness. There were significant negative correlations between smoking duration and rate with values of PFT (p < 0.05-p < 0.001. In this study the prevalence of smoking in population of Mashhad city was shown. The prevalence of smoking was higher among male than females. Smoking leads to increased respiratory symptoms and reduction of PFTs values. Resumen: A prevalência do acto de fumar foi estudada através de um questionário. Os testes de função pulmonar e sintomas respiratórios foram avaliados em 176 fumadores. O total da população estudada com família e colaboradores foi de 13289. O número de fumadores entre a população estudada foi de 11,7%. A taxa do acto de fumar entre os homens foi de 17,2% e de 2,5% entre as mulheres. Todos os valores de TFP nos fumadores foram significativamente inferiores (p < 0.001 e os sintomas respiratórios foram superiores em relação aos não fumadores (p < 0,05 para tosse e p < 0,001 para pieira e aperto torácico. Registaram-se correlações negativas significativas entre a duração do acto de fumar e a taxa com valores de TFP (p < 0,05-p < 0,001. Neste estudo, foi apresentada a prevalência do acto de fumar na população da cidade de Mashhad. A prevalência do acto de fumar foi maior entre os homens do que entre as mulheres. Fumar leva a um aumento de sintomas respiratórios e à redução dos valores de TFP. Keywords: Prevalence of smoking, smoking duration, smoking amount

  16. The terminal latency of the phrenic nerve correlates with respiratory symptoms in amyotrophic lateral sclerosis.

    Park, Jin-Sung; Park, Donghwi

    2017-09-01

    The aim of the study was to investigate the electrophysiological parameters in phrenic nerve conduction studies (NCS) that sensitively reflect latent respiratory insufficiency present in amyotrophic lateral sclerosis (ALS). Forty-nine patients with ALS were examined, and after exclusion, 21 patients with ALS and their phrenic NCS results were reviewed. The patients were divided into two groups according to their respiratory sub-score in the ALS functional rating scale - revised (Group A, sub-score 12vs. Group B, sub-score 11). We compared the parameters of phrenic NCS between the two groups. There were no significant differences in the clinical characteristics between the two groups. Using a multivariate model, we found that the terminal latency of the phrenic nerve was the only parameter that was associated with early symptoms of respiratory insufficiency (pphrenic nerve was 7.65ms (sensitivity 80%, specificity 68.2%). The significantly prolonged terminal latency of the phrenic nerve in our study may reflect a profound distal motor axonal dysfunction of the phrenic nerve in patients with ALS in the early stage of respiratory insufficiency that can be used as a sensitive electrophysiological marker reflecting respiratory symptoms in ALS. The terminal latency of the phrenic nerve is useful for early detection of respiratory insufficiency in patients with ALS. Copyright © 2017. Published by Elsevier B.V.

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

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

    2015-01-01

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

  18. QUOTAC: QUestionnaire On day and night Time respiratory symptoms in Asthmatic Children -- a validity study

    van Zaane, B.; Droog, R. P.; Stouthard, M. E. A.; van Aalderen, W. M. C.

    2007-01-01

    The aim of this study was to validate the QUOTAC, a questionnaire on day and night time respiratory symptoms in asthmatic children. Validity was examined by measuring agreement between the QUOTAC and a self-report diary in children aged 6 to 16 years, divided in an asthma group and a control group.

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

    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…

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

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

    1996-12-31

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

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

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

    1995-12-31

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

  2. Can a management pathway for chronic cough in children improve clinical outcomes: protocol for a multicentre evaluation

    Masters IB

    2010-11-01

    Full Text Available Abstract Background Chronic cough is common and is associated with significant economic and human costs. While cough can be a problematic symptom without serious consequences, it could also reflect a serious underlying illness. Evidence shows that the management of chronic cough in children needs to be improved. Our study tests the hypothesis that the management of chronic cough in children with an evidence-based management pathway is feasible and reliable, and improves clinical outcomes. Methods/Design We are conducting a multicentre randomised controlled trial based in respiratory clinics in 5 major Australian cities. Children (n = 250 fulfilling inclusion criteria (new patients with chronic cough are randomised (allocation concealed to the standardised clinical management pathway (specialist starts clinical pathway within 2 weeks or usual care (existing care until review by specialist at 6 weeks. Cough diary, cough-specific quality of life (QOL and generic QOL are collected at baseline and at 6, 10, 14, 26, and 52 weeks. Children are followed-up for 6 months after diagnosis and cough resolution (with at least monthly contact from study nurses. A random sample from each site will be independently examined to determine adherence to the pathway. Primary outcomes are group differences in QOL and proportion of children that are cough free at week 6. Discussion The clinical management pathway is based on data from Cochrane Reviews combined with collective clinical experience (250 doctor years. This study will provide additional evidence on the optimal management of chronic cough in children. Trial registration ACTRN12607000526471

  3. Design and characterization of a cough simulator.

    Zhang, Bo; Zhu, Chao; Ji, Zhiming; Lin, Chao-Hsin

    2017-02-23

    Expiratory droplets from human coughing have always been considered as potential carriers of pathogens, responsible for respiratory infectious disease transmission. To study the transmission of disease by human coughing, a transient repeatable cough simulator has been designed and built. Cough droplets are generated by different mechanisms, such as the breaking of mucus, condensation and high-speed atomization from different depths of the respiratory tract. These mechanisms in coughing produce droplets of different sizes, represented by a bimodal distribution of 'fine' and 'coarse' droplets. A cough simulator is hence designed to generate transient sprays with such bimodal characteristics. It consists of a pressurized gas tank, a nebulizer and an ejector, connected in series, which are controlled by computerized solenoid valves. The bimodal droplet size distribution is characterized for the coarse droplets and fine droplets, by fibrous collection and laser diffraction, respectively. The measured size distributions of coarse and fine droplets are reasonably represented by the Rosin-Rammler and log-normal distributions in probability density function, which leads to a bimodal distribution. To assess the hydrodynamic consequences of coughing including droplet vaporization and polydispersion, a Lagrangian model of droplet trajectories is established, with its ambient flow field predetermined from a computational fluid dynamics simulation.

  4. Cough-induced rib fractures.

    Sano, Atsushi; Tashiro, Ken; Fukuda, Tsutomu

    2015-10-01

    Occasionally, patients who complain of chest pain after the onset of coughing are diagnosed with rib fractures. We investigated the characteristics of cough-induced rib fractures. Between April 2008 and December 2013, 17 patients were referred to our hospital with chest pain after the onset of coughing. Rib radiography was performed, focusing on the location of the chest pain. When the patient had other signs and symptoms such as fever or persistent cough, computed tomography of the chest was carried out. We analyzed the data retrospectively. Rib fractures were found in 14 of the 17 patients. The age of the patients ranged from 14 to 86 years (median 39.5 years). Ten patients were female and 4 were male. Three patients had chronic lung disease. There was a single rib fracture in 9 patients, and 5 had two or more fractures. The middle and lower ribs were the most commonly involved; the 10th rib was fractured most frequently. Cough-induced rib fractures occur in every age group regardless of the presence or absence of underlying disease. Since rib fractures often occur in the lower and middle ribs, rib radiography is useful for diagnosis. © The Author(s) 2015.

  5. Human milk reduces outpatient upper respiratory symptoms in premature infants during their first year of life.

    Blaymore Bier, Jo-Ann; Oliver, Tanya; Ferguson, Anne; Vohr, Betty R

    2002-01-01

    To determine if ingestion of human milk after discharge reduces symptoms of infections in premature infants. Follow-up of 39 infants with birth weights milk and 15 of whom received only formula after discharge, was carried out. Mothers were given a calendar on which they recorded any signs of infections and feeding and day-care information. Data were collected at 1 month after discharge and at 3, 7, and 12 months corrected age. Results show no differences between groups in birth weight, gestation, gender, maternal age, parental tobacco use, number of siblings, and day-care attendance. Socioeconomic status score was higher in the human milk group. Infants who received human milk had fewer days of upper respiratory symptoms at 1 month after discharge (pmilk post discharge is associated with a reduction of upper respiratory symptoms in premature infants during their first year of life.

  6. Different impacts of respiratory symptoms and comorbidities on COPD-specific health-related quality of life by COPD severity

    Lee H

    2017-11-01

    George’s Respiratory Questionnaire for COPD (SGRQ-C score and forced expiratory volume in one second and investigated the factors responsible for high SGRQ-C score according to severity of airflow limitation.Methods: Data from 1,264 COPD patients were obtained from the Korean COPD Subgroup Study (KOCOSS cohort. Patients were categorized into two groups according to severity of airflow limitation: mild-to-moderate and severe-to-very severe COPD groups. We evaluated the clinical factors associated with high SGRQ-C score (≥25 in each COPD patient group.Results: Of the 1,264 COPD patients, 902 (71.4% had mild-to-moderate airflow limitation and 362 (28.6% had severe-to-very severe airflow limitation. Of the mild-to-moderate COPD patients, 59.2% (534/902 had high SGRQ-C score, while 80.4% (291/362 of the severe-to-very severe COPD patients had high SGRQ-C score. The association between SGRQ-C score and post-bronchodilator forced expiratory volume in one second (% predicted was very weak in the mild-to-moderate COPD patients (r=–0.103, p=0.002 and weak in the severe-to-very severe COPD patients (r=–0.219, p<0.001. Multiple logistic regression analysis revealed that age, being an ex- or current smoker, lower level of education, cough, dyspnea, and number of comorbidities with congestive heart failure, hyperlipidemia, and depression were significantly associated with high SGRQ-C score in mild-to-moderate COPD patients. In comparison, being an ex-smoker and having respiratory symptoms including sputum and dyspnea were significant factors associated with high SGRQ-C score in severe-to-very severe COPD patients.Conclusions: In addition to the respiratory symptoms of dyspnea and cough, high SGRQ-C score was associated with extra-pulmonary comorbidities in mild-to-moderate COPD patients. However, only respiratory symptoms such as sputum and dyspnea were significantly associated with high SGRQ-C score in severe-to-very severe COPD patients. This indicates the need for an

  7. Chest radiography in supporting the diagnosis of asthma in children with persistent cough.

    Halaby, Claudia; Feuerman, Martin; Barlev, Dan; Pirzada, Melodi

    2014-03-01

    To establish whether chest radiographic findings suggestive of lower airway obstruction (LAO) disease support the diagnosis of asthma in pediatric patients with persistent cough in an outpatient setting. 180 patient charts were reviewed. The patients were children aged 1 to 18 years referred over a 3-year period to a pediatric pulmonary subspecialty clinic for evaluation of cough lasting ≥ 4 weeks. Chest radiographic images obtained after the initial evaluation of 90 patients diagnosed with cough-variant asthma and 90 patients diagnosed with persistent cough from nonasthma origins were compared with radiologic findings of a control group consisting of patients with a positive tuberculin skin test and no respiratory symptoms. Increased peribronchial markings/peribronchial cuffing and hyperinflation were considered radiographically suggestive findings of LAO disease. Children diagnosed with cough-variant asthma at the initial evaluation had higher rates of chest radiographic findings suggestive of LAO disease (30.00%) than children with persistent cough from other causes (17.80%) or those with a positive tuberculin skin test and no respiratory symptoms (8.16%) (overall P value = 0.0063). They also had higher rates of spirometry abnormalities suggestive of an LAO defect. Children with chest radiographic findings suggestive of LAO disease were found to be younger than those with normal chest radiographic findings (5.0 ± 2.7 years vs 8.6 ± 4.7 years; P < 0.0001). This study suggests that chest radiographic findings indicative of an LAO in correlation with the clinical presentation can support the diagnostic suspicion of asthma, especially in younger children unable to perform spirometry.

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

    Anna Lucia Spear King

    2011-01-01

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

  9. Respiratory symptoms and lung function in garage workers and taxi drivers.

    Bener, A; Galadari, I; al-Mutawa, J K; al-Maskari, F; Das, M; Abuzeid, M S

    1998-12-01

    The aim of this study was to determine the prevalence of some respiratory symptoms and possible diseases among occupationally-exposed garage workers and taxi drivers. This study involved 158 garage workers and 165 taxi drivers, matched for age, sex, nationality and duration of employment. The mean age of 158 Indian subcontinent garage workers was 34.4 +/- 10.4 years; their mean height and weight were 167.7 +/- 6.6 cm and 72.0 +/- 12.3 kg respectively, and the mean duration of employment garage workers was 8.8 +/- 7.6 years. The mean age of 165 Indian subcontinent male taxi drivers was 34.5 +/- 7.7 years; their mean height and weight were 168.7 +/- 6.1 cm and 71.3 +/- 12.6 kg respectively; and the mean duration of employment was 7.5 +/- 5.4 years. The data on chronic respiratory symptoms showed that garage workers had higher prevalence of symptoms than taxi drivers being significantly greater for chronic phlegm, (p UAE), may be associated with the development of chronic respiratory symptoms and have effects on their daily life and health.

  10. Changes in respiratory and non-respiratory symptoms in occupants of a large office building over a period of moisture damage remediation attempts

    Cho, Sook Ja; White, Sandra K.; Cox-Ganser, Jean M.

    2018-01-01

    There is limited information on the natural history of building occupants’ health in relation to attempts to remediate moisture damage. We examined changes in respiratory and non-respiratory symptoms in 1,175 office building occupants over seven years with multiple remediation attempts. During each of four surveys, we categorized participants using a severity score: 0 = asymptomatic; 1 = mild, symptomatic in the last 12 months, but not frequently in the last 4 weeks; 2 = severe, symptomatic at least once weekly in the last 4 weeks. Building-related symptoms were defined as improving away from the building. We used random intercept models adjusted for demographics, smoking, building tenure, and microbial exposures to estimate temporal changes in the odds of building-related symptoms or severity scores independent of the effect of microbial exposures. Trend analyses of combined mild/severe symptoms showed no changes in the odds of respiratory symptoms but significant improvement in non-respiratory symptoms over time. Separate analyses showed increases in the odds of severe respiratory symptoms (odds ratio/year = 1.15‒1.16, p-valuesremediation efforts might not be effective in improving occupants’ health. PMID:29324816

  11. Should Controls With Respiratory Symptoms Be Excluded From Case-Control Studies of Pneumonia Etiology? Reflections From the PERCH Study.

    Higdon, Melissa M; Hammitt, Laura L; Deloria Knoll, Maria; Baggett, Henry C; Brooks, W Abdullah; Howie, Stephen R C; Kotloff, Karen L; Levine, Orin S; Madhi, Shabir A; Murdoch, David R; Scott, J Anthony G; Thea, Donald M; Driscoll, Amanda J; Karron, Ruth A; Park, Daniel E; Prosperi, Christine; Zeger, Scott L; O'Brien, Katherine L; Feikin, Daniel R

    2017-06-15

    Many pneumonia etiology case-control studies exclude controls with respiratory illness from enrollment or analyses. Herein we argue that selecting controls regardless of respiratory symptoms provides the least biased estimates of pneumonia etiology. We review 3 reasons investigators may choose to exclude controls with respiratory symptoms in light of epidemiologic principles of control selection and present data from the Pneumonia Etiology Research for Child Health (PERCH) study where relevant to assess their validity. We conclude that exclusion of controls with respiratory symptoms will result in biased estimates of etiology. Randomly selected community controls, with or without respiratory symptoms, as long as they do not meet the criteria for case-defining pneumonia, are most representative of the general population from which cases arose and the least subject to selection bias. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

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

    Majara Bosielo P

    2006-08-01

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

  13. Relationship between dental erosion and respiratory symptoms in patients with gastro-oesophageal reflux disease.

    Wang, Geng-Ru; Zhang, Hui; Wang, Zhong-Gao; Jiang, Guang-Shui; Guo, Cheng-Hao

    2010-11-01

    Both dental erosion and respiratory symptoms are extra-oesophageal manifestations of gastro-oesophageal reflux disease (GERD). The aim of this study was to determine whether dental erosion was correlated with respiratory symptoms in GERD patients. 88 GERD patients were recruited and assigned to three groups mainly according to the frequency of respiratory symptoms: Group I: never; Group II: occasional (1-2 days a week or less); Group III: frequent (3-5 days a week or more). All patients underwent medical evaluations, including medical history, questionnaire answering and alimentary tract examinations. Dental examinations were carried out on these patients and 36 healthy controls. Dental erosions were measured by modified method of Smith and Knight Tooth Wear Index (TWI). Location and severity of dental erosion were recorded. The prevalence of dental erosion in Group III (64.52%) was higher (pdental erosion with TWI scores ranging from 1 to 4. Though proportion of dental erosion with Score 2 (7/20) in Group III was higher than that in Group I (2/11) and Group II (3/12), there was no statistical significance in the proportions of erosion scores among three patient groups. Correlation coefficient between airway symptoms and scores of dental erosion was 0.231 (perosion of upper incisor was seen in 8 persons (72.7%) in Group I, 9 persons (75%) in Group II and 16 persons (80%) in Group III (p>0.05). Labial erosion of upper incisors was found in 1 person in Groups I and II respectively and 4 persons in Group III. All patients with labial erosion on upper incisors had palatal erosion, except 1 patient in Group III. In GERD patients, dental erosions are more prevalent in patients with frequent respiratory symptoms than those in patients with occasional and without respiratory symptoms. Palatal erosion of upper incisor is the main manifestation in patients. Acid reflux is the main causative factor of dental erosion in GERD patients with airway symptoms. Copyright © 2010

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

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

    2011-01-01

    in relation to asthma, chronic bronchitis, shortness of breath, and lung function level at examination 2 (1981-1983) or lung function decline established from examinations 1 (1976-1978) to 2 using 4 measures (FEV(1) slope, FEV(1) relative slope, American College of Occupational and Environmental Medicine......BACKGROUND: In workplace respiratory disease prevention, a thorough understanding is needed of the relative contributions of lung function loss and respiratory symptoms in predicting adverse health outcomes. METHODS: Copenhagen City Heart Study respiratory data collected at 4 examinations (1976......, the increasing trend in the HR (95% CI) by quartiles of the FEV(1) slope reached a maximum of 3.77 (2.76-5.15) for males, 6.12 (4.63-8.10) for females, and 4.14 (1.57-10.90) for never-smokers. Significant increasing trends were also observed for mortality, with females at higher risk. CONCLUSION: Lung function...

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

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

    2015-12-01

    Several studies have investigated the effect of livestock farm emissions on the respiratory health of local residents, but results are inconsistent. This study aims to explore associations between the presence of livestock farms and respiratory health in an area of high-density livestock farming in the Netherlands. We focused especially on associations between farm exposures and respiratory symptoms within subgroups of potentially susceptible patients with a pre-existing lung disease.In total, 14 875 adults (response rate 53.4%) completed a questionnaire concerning respiratory health, smoking habits and personal characteristics. Different indicators of livestock farm exposures relative to the home address were computed using a geographic information system.Prevalence of chronic obstructive pulmonary disease (COPD) and asthma was lower among residents living within 100 m of a farm (OR 0.47, 95% CI 0.24-0.91 and OR 0.65, 95% CI 0.45-0.93, respectively). However, >11 farms in 1000 m compared to fewer than four farms in 1000 m (fourth quartile versus first quartile) was associated with wheezing among COPD patients (OR 1.71, 95% CI 1.01-2.89). Using general practitioners' electronic medical records, we demonstrated that selection bias did not affect the observed associations.Our data suggest a protective effect of livestock farm emissions on the respiratory health of residents. Nonetheless, COPD patients living near livestock farms reported more respiratory symptoms, suggesting an increased risk of exacerbations. Copyright ©ERS 2015.

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

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

    2005-01-01

    consistent, supporting a unidimensional scale structure. Test-retest reliabilities for the percentage of SFD and CSS were above the recommended cut point of 0.70. Cross-sectional and longitudinal correlations were sizeable and statistically significant, demonstrating construct validity. Hypothesized known......Acute respiratory syncytial virus (RSV)-induced bronchiolitis is often associated with continuing respiratory symptoms following hospitalization. To date, there is no validated objective measure to evaluate symptoms of RSV-induced bronchiolitis. We report on the reliability, validity...... the 4-week treatment period of the reported prospective, placebo-controlled trial of montelukast for treatment of postacute RSV were used to assess reliability (internal consistency and test-retest), construct validity (cross-sectional and longitudinal correlations), discriminant validity (known...

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

    Hübner Nils-Olaf

    2010-08-01

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

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

    Hübner, Nils-Olaf; Hübner, Claudia; Wodny, Michael; Kampf, Günter; Kramer, Axel

    2010-08-24

    The economical impact of absenteeism and reduced productivity due to acute infectious respiratory and gastrointestinal disease is normally not in the focus of surveillance systems and may therefore be underestimated. However, large community studies in Europe and USA have shown that communicable diseases have a great impact on morbidity and lead to millions of lost days at work, school and university each year. Hand disinfection is acknowledged as key element for infection control, but its effect in open, work place settings is unclear. Our study involved a prospective, controlled, intervention-control group design to assess the epidemiological and economical impact of alcohol-based hand disinfectants use at work place. Volunteers in public administrations in the municipality of the city of Greifswald were randomized in two groups. Participants in the intervention group were provided with alcoholic hand disinfection, the control group was unchanged. Respiratory and gastrointestinal symptoms and days of work were recorded based on a monthly questionnaire over one year. On the whole, 1230 person months were evaluated. Hand disinfection reduced the number of episodes of illness for the majority of the registered symptoms. This effect became statistically significant for common cold (OR = 0.35 [0.17 - 0.71], p = 0.003), fever (OR = 0.38 [0.14-0.99], p = 0.035) and coughing (OR = 0.45 [0.22 - 0.91], p = 0.02). Participants in the intervention group reported less days ill for most symptoms assessed, e.g. colds (2.07 vs. 2.78%, p = 0.008), fever (0.25 vs. 0.31%, p = 0.037) and cough (1.85 vs. 2.00%, p = 0.024). For diarrhoea, the odds ratio for being absent became statistically significant too (0.11 (CI 0.01 - 0.93). Hand disinfection can easily be introduced and maintained outside clinical settings as part of the daily hand hygiene. Therefore it appears as an interesting, cost-efficient method within the scope of company health support programmes. ISRCTN96340690.

  19. Soy consumption and risk of COPD and respiratory symptoms: a case-control study in Japan.

    Hirayama, Fumi; Lee, Andy H; Binns, Colin W; Zhao, Yun; Hiramatsu, Tetsuo; Tanikawa, Yoshimasa; Nishimura, Koichi; Taniguchi, Hiroyuki

    2009-06-26

    To investigate the relationship between soy consumption, COPD risk and the prevalence of respiratory symptoms, a case-control study was conducted in Japan. A total of 278 eligible patients (244 men and 34 women), aged 50-75 years with COPD diagnosed within the past four years, were referred by respiratory physicians, while 340 controls (272 men and 68 women) were recruited from the community. All participants underwent spirometric measurements of respiratory function. Information on demographics, lifestyle characteristics and habitual food consumption was obtained using a structured questionnaire. Total soy consumption was positively correlated with observed lung function measures. The mean soy intake was significantly higher among controls (59.98, SD 50.23 g/day) than cases (44.84, SD 28.5 g/day). A significant reduction in COPD risk was evident for highest versus lowest quartile of daily intake of total soybean products, with adjusted odds ratio (OR) 0.392, 95% CI 0.194-0.793, p for trend 0.001. Similar decreases in COPD risk were associated with frequent and higher intake of soy foods such as tofu and bean sprouts, whereas respiratory symptoms were inversely associated with high consumption of soy foods, especially for breathlessness (OR 0.989, 95% CI 0.982-0.996). Increasing soy consumption was associated with a decreased risk of COPD and breathlessness.

  20. Examining the relation between respiratory sinus arrhythmia and depressive symptoms in emerging adults: A longitudinal study.

    Yaptangco, Mona; Crowell, Sheila E; Baucom, Brian R; Bride, Daniel L; Hansen, Erik J

    2015-09-01

    Major depressive disorder (MDD) is a debilitating and prevalent disorder associated with lower quality of life and substantial economic burden. Recently, there has been strong interest in respiratory sinus arrhythmia (RSA) as a biological predictor of later depression. Theoretical work suggests that higher resting RSA indexes physiological flexibility and better emotion regulation whereas lower RSA may mark vulnerability for psychopathology. However, empirical findings have varied. This study examined whether lower resting RSA predicted later depressive symptoms in a sample of healthy young adults across one year (n=185). Results indicate that year one (Y1) resting RSA predicted Y2 depressive symptoms. This finding remained significant when accounting for the stability of RSA and depressive symptoms across both time points and when including trait anxiety, body mass index, and medication use in statistical models. Findings provide further support for RSA as a promising biological marker for understanding and predicting depressive symptoms. Copyright © 2015 Elsevier B.V. All rights reserved.

  1. Pharmacology of Bradykinin-Evoked Coughing in Guinea Pigs

    Hewitt, Matthew M.; Adams, Gregory; Mazzone, Stuart B.; Mori, Nanako; Yu, Li; Canning, Brendan J.

    2016-01-01

    Bradykinin has been implicated as a mediator of the acute pathophysiological and inflammatory consequences of respiratory tract infections and in exacerbations of chronic diseases such as asthma. Bradykinin may also be a trigger for the coughing associated with these and other conditions. We have thus set out to evaluate the pharmacology of bradykinin-evoked coughing in guinea pigs. When inhaled, bradykinin induced paroxysmal coughing that was abolished by the bradykinin B2 receptor antagonis...

  2. Prevalence of respiratory symptoms in children and air quality by village in rural Indonesia.

    Hong, Ching-Ye; Chia, Sin-Eng; Widjaja, Daniel; Saw, Seang-Mei; Lee, Jeannette; Munoz, Canesio; Koh, David

    2004-11-01

    This study compared prevalence of respiratory symptoms in three Indonesian villages and related this to air quality. We interviewed caregivers of 382 children, using the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire, and monitored air quality during the survey period. Respiratory symptom prevalence was highest in Kerinci (40.5%), followed by SP7 (33.3%) and Pelalawan (19.8%). Compared with Pelalawan, adjusted odds ratios were 3.17 (95% confidence interval, 1.43-7.07) for Kerinci, and 2.03 (1.04-3.96) for SP7. Ambient air quality levels were highest in Kerinci for PM10 and hydrocarbon (means: 102.9 microg/m3, 10.5 microg/m3), followed by SP7 (73.7 microg/m3, 6.3 microg/m3) and Pelalawan (26.1 microg/m3, 4.7 microg/m3). The higher prevalence of respiratory symptoms in Kerinci and SP7 could be the result of higher PM10 and hydrocarbon levels in these locations.

  3. X-ray findings, lung function, and respiratory symptoms in black South African vermiculite workers

    Hessel, P.A.; Sluis-Cremer, G.K.

    1989-01-01

    Health effects have been documented among American vermiculite workers who mined and processed vermiculite contaminated with amphibole asbestos, viz., tremolite-actinolite. Workers mining and processing South Africa vermiculite (N = 172), which contains very little asbestos, underwent x-ray examination and lung function testing and completed a respiratory symptom questionnaire. The vermiculite workers were compared with other workers involved in the mining or refining of copper. Only two of the vermiculite workers showed evidence of small opacities of 1/0 or more (according to the ILO 1980 classification); lung function was comparable with the other groups of workers, and there was no excess of respiratory symptoms among the vermiculite workers. It is concluded that workers exposed to vermiculite that is minimally contaminated with asbestos are probably not at risk for pneumoconiosis, lung function impairment, or respiratory symptoms. It is likely that the health effects observed in other studies of vermiculite workers are the result of concomitant asbestos exposure. A risk of mesothelioma caused by the fiber content of the vermiculite cannot be excluded by this study

  4. Prevalence, diagnosis, and disease course of pertussis in adults with acute cough: a prospective, observational study in primary care.

    Teepe, Jolien; Broekhuizen, Berna D L; Ieven, Margareta; Loens, Katherine; Huygen, Kris; Kretzschmar, Mirjam; de Melker, Hester; Butler, Chris C; Little, Paul; Stuart, Beth; Coenen, Samuel; Goossens, Herman; Verheij, Theo J M

    2015-10-01

    Most cases of adult pertussis probably remain undiagnosed. To explore the prevalence, diagnosis, and disease course of acute pertussis infection in adult patients presenting with acute cough. Prospective observational study between 2007 and 2010 in primary care in 12 European countries. Adults presenting with acute cough (duration of ≤28 days) were included. Bordetella pertussis infection was determined by polymerase chain reaction (from nasopharyngeal flocked swabs and sputa) and by measurement of immunoglobulin G antibodies to pertussis toxin (PT) in venous blood at day 28. An antibody titre to PT of ≥125 IU/ml or PCR positive result in a respiratory sample defined recent infection. Patients completed a symptom diary for 28 days. Serum and/or respiratory samples were obtained in 3074 patients. Three per cent (93/3074) had recent B. pertussis infection. Prior cough duration >2 weeks discriminated to some extent between those with and without pertussis (adjusted odds ratio 1.89, 95% confidence interval = 1.17 to 3.07; P = 0.010). Median cough duration after presentation was 17 and 12 days in patients with and without pertussis, respectively (P = 0.008). Patients with pertussis had longer duration of phlegm production (P = 0.010), shortness of breath (P = 0.037), disturbed sleep (P = 0.013) and interference with normal activities or work (P = 0.033) after presentation. Pertussis infection plays a limited role among adults presenting with acute cough in primary care, but GPs should acknowledge the possibility of pertussis in uncomplicated lower respiratory tract infection. As in children, pertussis also causes prolonged symptoms in adults. However, pertussis is difficult to discern from other acute cough syndromes in adults at first presentation. © British Journal of General Practice 2015.

  5. Airway ciliary dysfunction and respiratory symptoms in patients with transposition of the great arteries.

    Zahid, Maliha; Bais, Abha; Tian, Xin; Devine, William; Lee, Dong Ming; Yau, Cyrus; Sonnenberg, Daniel; Beerman, Lee; Khalifa, Omar; Lo, Cecilia W

    2018-01-01

    Our prior work on congenital heart disease (CHD) with heterotaxy, a birth defect involving randomized left-right patterning, has shown an association of a high prevalence of airway ciliary dysfunction (CD; 18/43 or 42%) with increased respiratory symptoms. Furthermore, heterotaxy patients with ciliary dysfunction were shown to have more postsurgical pulmonary morbidities. These findings are likely a reflection of the common role of motile cilia in both airway clearance and left-right patterning. As CHD comprising transposition of the great arteries (TGA) is commonly thought to involve disturbance of left-right patterning, especially L-TGA with left-right ventricular inversion, we hypothesize CHD patients with transposition of great arteries (TGA) may have high prevalence of airway CD with increased respiratory symptoms. We recruited 75 CHD patients with isolated TGA, 28% L and 72% D-TGA. Patients were assessed using two tests typically used for evaluating airway ciliary dysfunction in patients with primary ciliary dyskinesia (PCD), a recessive sinopulmonary disease caused by respiratory ciliary dysfunction. This entailed the measurement of nasal nitric oxide (nNO), which is typically low with PCD. We also obtained nasal scrapes and conducted videomicroscopy to assess respiratory ciliary motion (CM). We observed low nNO in 29% of the patients, and abnormal CM in 57%, with 22% showing both low nNO and abnormal CM. No difference was observed for the prevalence of either low nNO or abnormal ciliary motion between patients with D vs. L-TGA. Respiratory symptoms were increased with abnormal CM, but not low nNO. Sequencing analysis showed no compound heterozygous or homozygous mutations in 39 genes known to cause PCD, nor in CFTR, gene causing cystic fibrosis. As both are recessive disorders, these results indicate TGA patients with ciliary dysfunction do not have PCD or cystic fibrosis (which can cause low nNO or abnormal ciliary motion). TGA patients have high

  6. Prevalence of cough throughout childhood: A cohort study.

    Maja Jurca

    Full Text Available Cough in children is a common reason for medical consultations and affects quality of life. There are little population-based data on the epidemiology of recurrent cough in children and how this varies by age and sex, or between children with and without wheeze. We determined the prevalence of cough throughout childhood, comparing several standardised cough questions. We did this for the entire population and separately for girls and boys, and for children with and without wheeze.In a population-based prospective cohort from Leicestershire, UK, we assessed prevalence of cough with repeated questionnaires from early childhood to adolescence. We asked whether the child usually coughed more than other children, with or without colds, had night-time cough or cough triggered by various factors (triggers, related to increased breathing effort, allergic or food triggers. We calculated prevalence from age 1 to 18 years using generalised estimating equations for all children, and for children with and without wheeze.Of 7670 children, 10% (95% CI 10-11% coughed more than other children, 69% (69-70% coughed usually with a cold, 34% to 55% age-dependently coughed without colds, and 25% (25-26% had night-time cough. Prevalence of coughing more than peers, with colds, at night, and triggered by laughter varied little throughout childhood, while cough without colds and cough triggered by exercise, house dust or pollen became more frequent with age. Cough was more common in boys than in girls in the first decade of life, differences got smaller in early teens and reversed after the age of 14 years. All symptoms were more frequent in children with wheeze.Prevalence of cough in children varies with age, sex and with the questions used to assess it, suggesting that comparisons between studies are only valid for similar questions and age groups.

  7. The Impact of Air Pollution, Including Asian Sand Dust, on Respiratory Symptoms and Health-related Quality of Life in Outpatients With Chronic Respiratory Disease in Korea: A Panel Study.

    Nakao, Motoyuki; Ishihara, Yoko; Kim, Cheol-Hong; Hyun, In-Gyu

    2018-05-01

    Air pollution is a growing concern in Korea because of transboundary air pollution from mainland China. A panel study was conducted to clarify the effects of air pollution on respiratory symptoms and health-related quality of life (HR-QoL) in outpatients with and without chronic obstructive pulmonary disease (COPD) in Korea. Patients filled out a questionnaire including self-reported HR-QoL in February and were followed up in May and July. The study was conducted from 2013 to 2015, with different participants each year. Air quality parameters were applied in a generalized estimating equation as independent variables to predict factors affecting HR-QoL. Lower physical fitness scores were associated with Asian sand dust events. Daily activity scores were worse when there were high concentrations of particulate matter (PM) less than 10 μm in diameter (PM 10 ). Lower social functioning scores were associated with high PM less than 2.5 μm in diameter and nitrogen dioxide (NO 2 ) concentrations. High NO 2 concentrations also showed a significant association with mental health scores. Weather-related cough was prevalent when PM 10 , NO 2 , or ozone (O 3 ) concentrations were high, regardless of COPD severity. High PM 10 concentrations were associated with worsened wheezing, particularly in COPD patients. The results suggest that PM, NO 2 , and O 3 cause respiratory symptoms leading to HR-QoL deterioration. While some adverse effects of air pollution appeared to occur regardless of COPD, others occurred more often and more intensely in COPD patients. The public sector, therefore, needs to consider tailoring air pollution countermeasures to people with different conditions to minimize adverse health effects.

  8. The Impact of Air Pollution, Including Asian Sand Dust, on Respiratory Symptoms and Health-related Quality of Life in Outpatients With Chronic Respiratory Disease in Korea: A Panel Study

    Motoyuki Nakao

    2018-05-01

    Full Text Available Objectives Air pollution is a growing concern in Korea because of transboundary air pollution from mainland China. A panel study was conducted to clarify the effects of air pollution on respiratory symptoms and health-related quality of life (HR-QoL in outpatients with and without chronic obstructive pulmonary disease (COPD in Korea. Methods Patients filled out a questionnaire including self-reported HR-QoL in February and were followed up in May and July. The study was conducted from 2013 to 2015, with different participants each year. Air quality parameters were applied in a generalized estimating equation as independent variables to predict factors affecting HR-QoL. Results Lower physical fitness scores were associated with Asian sand dust events. Daily activity scores were worse when there were high concentrations of particulate matter (PM less than 10 μm in diameter (PM10. Lower social functioning scores were associated with high PM less than 2.5 μm in diameter and nitrogen dioxide (NO2 concentrations. High NO2 concentrations also showed a significant association with mental health scores. Weather-related cough was prevalent when PM10, NO2, or ozone (O3 concentrations were high, regardless of COPD severity. High PM10 concentrations were associated with worsened wheezing, particularly in COPD patients. Conclusions The results suggest that PM, NO2, and O3 cause respiratory symptoms leading to HR-QoL deterioration. While some adverse effects of air pollution appeared to occur regardless of COPD, others occurred more often and more intensely in COPD patients. The public sector, therefore, needs to consider tailoring air pollution countermeasures to people with different conditions to minimize adverse health effects.

  9. Pseudo-asthma: when cough, wheezing, and dyspnea are not asthma.

    Weinberger, Miles; Abu-Hasan, Mutasim

    2007-10-01

    Although asthma is the most common cause of cough, wheeze, and dyspnea in children and adults, asthma is often attributed inappropriately to symptoms from other causes. Cough that is misdiagnosed as asthma can occur with pertussis, cystic fibrosis, primary ciliary dyskinesia, airway abnormalities such as tracheomalacia and bronchomalacia, chronic purulent or suppurative bronchitis in young children, and habit-cough syndrome. The respiratory sounds that occur with the upper airway obstruction caused by the various manifestations of the vocal cord dysfunction syndrome or the less common exercise-induced laryngomalacia are often mischaracterized as wheezing and attributed to asthma. The perception of dyspnea is a prominent symptom of hyperventilation attacks. This can occur in those with or without asthma, and patients with asthma may not readily distinguish the perceived dyspnea of a hyperventilation attack from the acute airway obstruction of asthma. Dyspnea on exertion, in the absence of other symptoms of asthma or an unequivocal response to albuterol, is most likely a result of other causes. Most common is the dyspnea associated with normal exercise limitation, but causes of dyspnea on exertion can include other physiologic abnormalities including exercise-induced vocal cord dysfunction, exercise-induced laryngomalacia, exercise-induced hyperventilation, and exercise-induced supraventricular tachycardia. A careful history, attention to the nature of the respiratory sounds that are present, spirometry, exercise testing, and blood-gas measurement provide useful data to sort out the various causes and avoid inappropriate treatment of these pseudo-asthma clinical manifestations.

  10. Isotopic evaluation of nasal mucociliary transport in patients with chronic respiratory symptoms

    Opazo, C.; Troncoso, M.; Quilodran, C.; Lizama, V.

    2002-01-01

    Introduction: There are a large number of patients with chronic respiratory symptoms especially in pediatric population in whom it would be important to rule out primary ciliary dyskinesia (PCD) by electron microscopic examination of cilia obtained from respiratory mucosal biopsies, an expensive and not widely available procedure. Our purpose was to evaluate the role of the radioisotopic mucociliary transport measurement on selecting patients for nasal or tracheobronchial biopsy. Methods: The velocity of nasal mucociliary transport (VNMT) was measured in 100 patients, aged 2m-39y, mean 9 yo, from feb-1999 until feb-2002. Ten were healthy controls. The others had chronic o recurrent respiratory symptoms. The procedure consisted to place a 99m Tc-MAA droplet in one nostril by direct vision and follows its course using a gammacamera-computer system in order to calculate its speed expressed in mm/min. Sedation was needed in the vast majority of children below 4 yo. Values below 3 mm/min were repeated to ensure an accurate result. All cases having VNMT below 2,5 mm/min underwent nasal mucosal biopsy. In some patients with VNMT above 2,5 mm/min, nasal mucosal biopsy was also done based on other considerations. Patients were classified in three groups. Those having respiratory symptoms and no biopsy done (CRRS.NB); patients with respiratory symptoms and PCD diagnosed by biopsy (CRRS.PCD.B (+)); healthy controls. Results: Al cases with CRRS. PCD.B(+) had VNMT below 2.4 mm/min with a mean significantly different from those in CRRS.NB and healthy controls. There were no overlapping between the VNMT highest value in patients having CRRS. PCD.B(+) and the lowest VNMT in CRRS.NB or healthy controls. The results are similar to those published by other centers. Conclusions: The radioisotopic method to measure VNMT is feasible, inexpensive and relatively easy to perform. As PCD has important differences in prognosis and treatment from other conditions with similar symptoms, it is

  11. Chlamydiae in febrile children with respiratory tract symptoms and age-matched controls, Ghana

    H. Bühl

    2018-03-01

    Full Text Available Members of the Chlamydiales order are obligate intracellular pathogens causing acute and chronic infectious diseases. Chlamydiaceae are established agents of community- and zoonotically acquired respiratory tract infections, and emerging pathogens among the Chlamydia-related bacteria have been implicated in airway infections. The role of both in airway infections in Africa is underexplored. We performed a case -control study on the prevalence of Chlamydiaceae and Chlamydia-related emerging pathogens in children with febrile respiratory tract infections in West Africa, Ghana. Using a pan-Chlamydiales broad-range real-time PCR, we detected chlamydial DNA in 11 (1.9% of 572 hospitalized febrile children with respiratory tract symptoms and in 24 (4.3% of 560 asymptomatic age-matched controls (p 0.03. Chlamydiaceae were found to be common among both symptomatic and healthy Ghanaian children, with Chlamydia pneumoniae being the most prevalent species. Parachlamydiaceae were detected in two children without symptoms but not in the symptomatic group. We identified neither Chlamydia psittaci nor Simkania negevensis but a member of a new chlamydial family that shared 90.2% sequence identity with the 16S rRNA gene of the zoonotic pathogen Chlamydia pecorum. In addition, we found a new Chlamydia-related species that belonged to a novel family sharing 91.3% 16S rRNA sequence identity with Candidatus Syngnamydia venezia. The prevalence and spectrum of chlamydial species differed from previous results obtained from children of other geographic regions and our study indicates that both, Chlamydiaceae and Chlamydia-related bacteria, are not clearly linked to clinical symptoms in Ghanaian children. Keywords: Children, Chlamydia, Chlamydia-related bacteria, febrile respiratory tract infection, Ghana

  12. Cough in children.

    Lamas, Adelaida; Ruiz de Valbuena, Marta; Máiz, Luis

    2014-07-01

    Cough during childhood is very common, and is one of the most frequent reasons for consultation in daily pediatric practice. The causes differ from those in adults, and specific pediatric guidelines should be followed for correct diagnosis and treatment. The most common cause of cough in children is viral infection producing "normal cough", but all children with persistent cough, i.e. a cough lasting more than 4-8weeks or "chronic cough", must be carefully evaluated in other to rule out specific causes that may include the entire pediatric pulmonology spectrum. The treatment of cough should be based on the etiology. Around 80% of cases can be diagnosed using an optimal approach, and treatment will be effective in 90% of them. In some cases of "nonspecific chronic cough", in which no underlying condition can be found, empirical treatment based on the cough characteristics may be useful. There is no scientific evidence to justify the use of over-the-counter cough remedies (anti-tussives, mucolytics and/or antihistamines), as they could have potentially serious side effects, and thus should not be prescribed in children. Copyright © 2013 SEPAR. Published by Elsevier Espana. All rights reserved.

  13. Respiratory symptoms necessitating spirometry among soldiers with Iraq/Afghanistan war lung injury.

    Szema, Anthony M; Salihi, Walid; Savary, Khalil; Chen, John J

    2011-09-01

    New-onset asthma rates are higher among US soldiers deployed to Iraq/Afghanistan than stateside, but overall respiratory symptom and spirometry rates among soldiers returning from Iraq/Afghanistan have not yet been addressed. We determined these rates in soldiers deployed to Iraq/Afghanistan versus troops stationed elsewhere. Retrospective review of active-duty soldiers (2004 to 2010) registered at Veterans Affairs Medical Center, Northport, New York, with Long Island/New York City zip codes. Subjects were examined by physicians or physicians' assistants. We counted number of spirometries, which required respiratory symptoms, and the provider was required to submit a diagnosis as part of the request process. Twenty-five percent of 7151 troops went to Iraq/Afghanistan (n = 1816) and 75% went elsewhere (n = 5335), with more smokers in the Iraq/Afghanistan group (16.1% vs 3.3%). Rates of symptoms and spirometry were 14.5% and 1.8%, for Iraq/Afghanistan, versus troops deployed elsewhere, respectively (P Afghanistan war lung injury is common and rates of symptoms leading to a diagnosis requiring spirometry are high. (C)2011The American College of Occupational and Environmental Medicine

  14. A Longitudinal Study of Association between Heavy Metals and Itchy Eyes, Coughing in Chronic Cough Patients: Related with Non-Immunoglobulin E Mediated Mechanism

    Thao Thi Thu Nguyen

    2016-01-01

    Full Text Available The association between heavy metals exposure and respiratory diseases or allergic sensitization showing high serum immunoglobulin E (IgE has been suggested. However, previous findings have been inconsistent and the mechanisms responsible remain unclear. We evaluated heavy metal exposure and its association with coughing, itchy eyes in chronic cough patients with different IgE levels. Ninety outpatients in Kanazawa University Hospital were recruited between January–June 2011. Subjects whose total IgE measured by radioimmunosorbent test were asked to record their daily symptoms. We collected daily total suspended particles (TSP from which concentrations of calcium (Ca, cadmium (Cd, chromium (Cr, iron (Fe, manganese (Mn, nickel (Ni, and lead (Pb were determined then divided into high and low level groups. Generalized estimating equations were applied to compute the relationship between concentrations of these metals and symptoms. All metals at high levels were significantly associated with itchy eyes compared with low levels, with exception of Ca, the six others were significant in patients with IgE < 250 IU/mL. Cd, Fe, Mn had association with coughing (odds ratio-OR (95% confidence interval-CI: 1.13 (1.03, 1.24, 1.22 (1.05, 1.42, and 1.13 (1.01, 1.27, respectively, this relationship remained significant for Cd (OR (95% CI: 1.14 (1.03, 1.27 and Mn (OR (95% CI: 1.15 (1.00, 1.31 in patients with lower IgE. Our findings demonstrate the relationship between aerial heavy metals and itchy eyes, coughing in chronic cough patients, suggesting these symptoms may be due to a non-IgE mediated mechanism.

  15. Urinary leukotriene E(4), eosinophil protein X, and nasal eosinophil cationic protein are not associated with respiratory symptoms in 1-year-old children.

    Wojnarowski, C; Halmerbauer, G; Mayatepek, E; Gartner, C; Frischer, T; Forster, J; Kuehr, J

    2001-09-01

    Eosinophilic airways inflammation forms the pathophysiologic basis for a proportion of children at risk of developing recurrent wheezing. Early preventive measures and/or anti-inflammatory treatment may be guided by the identification of such children. We aimed to study the relationship between respiratory symptoms and indirect markers of airway inflammation. We measured eosinophil protein X (EPX) and leukotriene E(4) (LTE(4)) in urine, as well as eosinophil cationic protein (ECP) in nasal lavages, in a random sample of 1-year-old children with a family history of atopy who participated in an international multicenter study on the prevention of allergy in Europe. For urine analyses, 10 children with upper respiratory illness and 19 healthy children without a family history of atopy were also enrolled. Endogenous urinary LTE(4) was separated by HPLC and determined by enzyme immunoassay with a specific antibody. The concentrations of nasal ECP and urinary EPX were determined by RIA analysis. One hundred and ten children (mean age: 1.05+/-0.1 years) were enrolled. Prolonged coughing during the first year of life was reported in 29 children, wheezy breathing in 17 children, and dry skin in 33 children. A doctor's diagnosis of wheezy bronchitis was given to 17 children. Sensitization to dust mites (specific IgE > or =1.43 ML/units) was detected in two children. Children with a doctor's diagnosis of atopic dermatitis within the first 12 months of life (n=6) had significantly higher urinary EPX than children without this (66.7 vs 30.1 microg/mmol creatinine, P=0.01). Urinary excretion of EPX and LTE4 showed a weak correlation (r=0.22, P=0.02). There were no significant differences in urinary excretion of EPX and LTE(4) or nasal ECP between children with and without respiratory symptoms (P>0.1). At the age of 1 year, urinary EPX is increased in children with atopic dermatitis. With regard to respiratory symptoms, urinary and nasal inflammatory parameters are not helpful in

  16. A cross-sectional study of lung function and respiratory symptoms among chemical workers producing diacetyl for food flavourings.

    van Rooy, F.G.; Smit, L.A.; Houba, R.; Zaat, V.A.; Rooijackers, J.M.; Heederik, D.J.J.

    2009-01-01

    OBJECTIVES: Four diacetyl workers were found to have bronchiolitis obliterans syndrome. Exposures, respiratory symptoms, lung function and exposure-response relationships were investigated. METHODS: 175 workers from a plant producing diacetyl between 1960 and 2003 were investigated. Exposure data

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

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

    2012-01-01

    . Patients were included if one or more of the following symptoms or clinical findings were present: respiratory rate > 20, saturation chest pain. Within one hour after the primary evaluation, focused sonography of the heart, lungs and deep veins...

  18. Assessment of respiratory symptoms and lung function values among the brick field workers of West Bengal, India.

    Das, Banibrata

    2016-07-03

    Brick manufacturing process releases large amounts of silica dust into the work environment due to the use of silica-containing materials. The main aim of the study was to investigate the impairment of lung function and prevalence of respiratory symptoms among the different groups of brick field workers in comparison with control subjects. A total of 250 brick field workers and 130 unexposed control subjects were randomly selected in which demographic characteristics, respiratory symptoms, and lung function values were recorded. The result showed significantly lower p value (workers when compared with control group. The prevalence of respiratory symptoms was dyspnea (46.8%), phlegm (39.2%), and chest tightness (27.6%). Dust exposure in working environment affected the lung function values and increased the respiratory symptoms among the brick field workers.

  19. Early respiratory and skin symptoms in relation to ethnic background : The importance of socioeconomic status; the PIAMA study

    Koopman, LP; Wijga, A; Smit, HA; de Jongste, JC; Kerkhof, M; Gerritsen, J; Vos, APH; van Strien, RT; Brunekreef, B; Neijens, HJ

    2002-01-01

    Aims: To evaluate ethnic differences in the prevalence of respiratory and skin symptoms in the first two years of life. Methods: A total of 4 146 children participated in the Prevention and Incidence of Asthma and Mite Allergy (PIAMA) study. Parents completed questionnaires on respiratory and skin

  20. Prevalence of respiratory symptoms and their correlation to pulmonary function abnormalities in individuals exposed to environmental pollution

    Khalid, G.H.; Ali, M.; Ahmed, J.; Abbas, M.N.

    1999-01-01

    To find out the prevalence of respiratory symptoms and their correlation to pulmonary function abnormalities in individuals exposed to polluted air, 438 workers, and their family members were studied at Thermal Power Station (TPS), Sheikhmanda (Quetta). Individuals with a stay of less than three years at TPS and patients with known chronic respiratory infections (tuberculosis and its squelae, bronchiectasis) were excluded from the study. Remaining 175 males (mean age 43.4 years) and 71 females (mean age 34.2 years) were divided into three groups A, B, C on the basis of their exposure time to polluted air per day during the three years. Each groups was further subdivided into smoker and non-smoker members. Prevalence of respiratory symptoms was significantly higher in the individuals exposed to polluted air as compared to non-exposed individuals (P<0.05). A strong positive correlation (r=0.91) exists between respiratory symptoms and respiratory function abnormalities in smoker groups; however, no definite correlation (r=0.06) was found between respiratory symptoms and respiratory function abnormalities in non-smoker groups. Function abnormalities was noted only in smoker groups and non-smokers of even maximally exposed group (group C) had almost no respiratory function abnormalities. (author)

  1. Respiratory

    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.

  2. Respiratory symptoms and active tuberculosis in a prison in Southern Brazil: associated epidemiologic variables

    Jeane Zanini Rocha

    2013-10-01

    Full Text Available Backgound and Objectives: This study is justified by the high TB prevalence in prisons, which constitutes a public health problem and aims to estimate the prevalence of active tuberculosis (TB and determine the variables associated with respiratory symptoms in a prison in Brazil. Methods: This is a descriptive study of 262 inmates divided into respiratory symptomatic and asymptomatic groups. Samples were evaluated by microscopy following the cultivation of the sputum from symptomatic individuals. Associated epidemiological variables were also evaluated. Results: Among the 262 inmates included, 178 (68% were considered symptomatic, and of these, 25 (14% were diagnosed with active TB. The contribution of culturing in the detection of TB cases was 48%. The prevalence of active TB was 9,542/100.000. Low educational level, use of drugs and alcohol, prison recidivism, and previous TB and HIV-positive status were associated with the presence of respiratory symptoms. Being male, single, black, a prison recidivist, an alcoholic and HIV-seropositive was associated with the development of TB. The rate of TB/HIV co infection was 60%. The outcome was death in 12% of patients. Drug therapy interruption was reported by 96% of patients. Conclusions: The studied population showed a high prevalence of TB and TB/HIV co-infection. In addition, the rates of drug therapy interruption and mortality were alarmingly elevated. KEYWORDS: Epidemiology. Tuberculosis. Coinfections. HIV infection. Prisons.

  3. Recognizing and Preventing Whooping Cough 2 (Pertussis)

    2010-09-16

    This podcast encourages everyone to get vaccinated against whooping cough (pertussis), especially those who will have close contact with an infant.  Created: 9/16/2010 by National Center for Immunization and Respiratory Diseases (NCIRD).   Date Released: 9/16/2010.

  4. Particulate matter air pollution and respiratory symptoms in individuals having either asthma or chronic obstructive pulmonary disease: a European multicentre panel study.

    Karakatsani, Anna; Analitis, Antonis; Perifanou, Dimitra; Ayres, Jon G; Harrison, Roy M; Kotronarou, Anastasia; Kavouras, Ilias G; Pekkanen, Juha; Hämeri, Kaarle; Kos, Gerard Pa; de Hartog, Jeroen J; Hoek, Gerard; Katsouyanni, Klea

    2012-10-05

    Particulate matter air pollution has been associated with adverse health effects. The fraction of ambient particles that are mainly responsible for the observed health effects is still a matter of controversy. Better characterization of the health relevant particle fraction will have major implications for air quality policy since it will determine which sources should be controlled.The RUPIOH study, an EU-funded multicentre study, was designed to examine the distribution of various ambient particle metrics in four European cities (Amsterdam, Athens, Birmingham, Helsinki) and assess their health effects in participants with asthma or COPD, based on a detailed exposure assessment. In this paper the association of central site measurements with respiratory symptoms and restriction of activities is examined. At each centre a panel of participants with either asthma or COPD recorded respiratory symptoms and restriction of activities in a diary for six months. Exposure assessment included simultaneous measurements of coarse, fine and ultrafine particles at a central site. Data on gaseous pollutants were also collected. The associations of the 24-hour average concentrations of air pollution indices with the health outcomes were assessed in a hierarchical modelling approach. A city specific analysis controlling for potential confounders was followed by a meta-analysis to provide overall effect estimates. A 10 μg/m3 increase in previous day coarse particles concentrations was positively associated with most symptoms (an increase of 0.6 to 0.7% in average) and limitation in walking (OR= 1.076, 95% CI: 1.026-1.128). Same day, previous day and previous two days ozone concentrations were positively associated with cough (OR= 1.061, 95% CI: 1.013-1.111; OR= 1.049, 95% CI: 1.016-1.083 and OR= 1.059, 95% CI: 1.027-1.091, respectively). No consistent associations were observed between fine particle concentrations, nitrogen dioxide and respiratory health effects. As for particle

  5. Prevalence of allergy and upper respiratory tract symptoms in runners of the London marathon.

    Robson-Ansley, Paula; Howatson, Glyn; Tallent, Jamie; Mitcheson, Kelly; Walshe, Ian; Toms, Chris; DU Toit, George; Smith, Matt; Ansley, Les

    2012-06-01

    The prevalence of self-reported upper respiratory tract (URT) symptoms in athletes has been traditionally associated with opportunistic infection during the temporal suppression of immune function after prolonged exercise. There is little evidence for this, and a competing noninfectious hypothesis has been proposed, whereby the exercise-induced immune system modulations favor the development of atopy and allergic disease, which manifests as URT symptoms. The aim of this study was to examine the association between allergy and URT symptoms in runners after an endurance running event. Two hundred eight runners from the 2010 London Marathon completed the validated Allergy Questionnaire for Athletes (AQUA) and had serum analyzed for total and specific immunoglobulin E response to common inhalant allergens. Participants who completed the marathon and nonrunning controls who lived in the same household were asked to complete a diary on URT symptoms. Forty percent of runners had allergy as defined by both a positive AQUA and elevated specific immunoglobulin E. Forty-seven percent of runners experienced URT symptoms after the marathon. A positive AQUA was a significant predictor of postmarathon URT symptoms in runners. Only 19% of nonrunning controls reported symptoms. The prevalence of allergy in recreational marathon runners was similar to that in elite athletes and higher than that in the general population. There was a strong association between a positive AQUA and URT symptoms. The low proportion of households in which both runners and nonrunners were symptomatic suggests that the nature of symptoms may be allergic or inflammatory based rather than infectious. Allergy is a treatable condition, and its potential effect on performance and health may be avoided by accurate clinical diagnosis and management. Both athletes' and coaches' awareness of the potential implications of poorly managed allergy needs to be raised.

  6. Pregnancy and Whooping Cough

    ... cough vaccine recommendation for pregnant women, infants and children, preteens and teens, and adults. You may print ... Vaccinating Pregnant Patients Answering Patient Questions Making a Strong ...

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

    Renata André Laurino

    2012-11-01

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

  8. Respiratory effects of borax dust.

    Garabrant, D H; Bernstein, L; Peters, J M; Smith, T J; Wright, W E

    1985-12-01

    The relation of respiratory symptoms, pulmonary function, and abnormalities of chest radiographs to estimated exposures of borax dust has been investigated in a cross sectional study of 629 actively employed borax workers. Ninety three per cent of the eligible workers participated in the study and exposures ranged from 1.1 mg/m3 to 14.6 mg/m3. Symptoms of acute respiratory irritation such as dryness of the mouth, nose, or throat, dry cough, nose bleeds, sore throat, productive cough, shortness of breath, and chest tightness were related to exposures of 4.0 mg/m3 or more, and were infrequent at exposures of 1.1 mg/m3. Symptoms of persistent respiratory irritation meeting the definition of chronic simple bronchitis were related to exposure among non-smokers. Decrements in the FEV1 as a percentage of predicted were seen among smokers who had heavy cumulative borax exposures (greater than or equal to 80 mg/m3 years) but were not seen among less exposed smokers or among non-smokers. Radiographic abnormalities were uncommon and were not related to dust exposure. Borax dust appears to act as a simple respiratory irritant and perhaps causes small changes in the FEV1 among smokers who are heavily exposed.

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

    Gregor Porebski

    2014-11-01

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

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

    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...

  11. Increasing prevalence of asthma, respiratory symptoms, and allergic diseases: Four repeated surveys from 1993-2014.

    Brozek, Grzegorz; Lawson, Joshua; Szumilas, Dawid; Zejda, Jan

    2015-08-01

    Published data shows different prevalence trends depending on the region of Europe. The aim of the study was to analyze time trends of the frequency of the respiratory symptoms and allergic diseases in school children (Silesia, Poland) over the last 21 years. We compared the results of four population-based surveys performed in a town of Chorzow in 1993, 2002, 2007 and 2014 in children aged 7-10 years. All four studies had the same study protocol, recruitment (cluster, school-based sampling), questionnaire (WHO respiratory health questionnaire) and the same principal investigator The surveys included 1130 children in 1993, 1421 children in 2002, 1661 children in 2007 and 1698 in 2014. The results covered a 21 year span and showed a statistically significant (p increase in the prevalence of the following physician-diagnosed disorders (1993-2002-2007-2014): asthma (3.4%-4.8%-8.6%-12,6%); allergic rhinitis (4.3%-11.9%-15.9%-13.9%); atopic dermatitis (3.6%-7.9%-12.0%-13.9%); allergic conjunctivitis (4.3%-7.9%-8.3%-7.9%); A simultaneous increasing trend (p increased proportion of treated children (51.3%-51.3%-69.5%-60.7%) and a lower frequency of presenting current symptoms. Our findings are in line with the concept of a real increase in the occurrence of asthma and allergic disease in children. The pattern involves not only physician-diagnosed allergic diseases but also occurrence of symptoms related to respiratory disorders. Diagnosed asthma is better treated and better controlled. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. Efficacy of omeprazole on cough, pulmonary function and quality of life of patients with sulfur mustard lung injury: A placebo-control, cross-over clinical trial study

    Mohammad Hossein Emami

    2014-01-01

    Full Text Available Background: Gastro-esophageal reflux disease (GERD is prevalent and related to more severe disease in patients with respiratory problems. We evaluated the effects of antireflux therapy in warfare victims of exposure to Mustard gas with chronic cough. Materials and Methods: This randomized, double-blind, placebo-controlled, cross-over study was conducted on 45 cases of sulfur mustard injury with chronic cough (≥8 weeks and GERD. Patients were randomized into two groups, receiving either 20 mg twice daily omeprazole-placebo (OP or matching placebo (placebo-omeprazole [PO] for 4 months, followed by a 1-month washout period and the alternative treatment for 4 months. Assessments included GERD and cough, quality of life, and pulmonary function using spirometry. Leicester Cough Questionnaire and SF-36 were used for measuring quality of life. Results: Patients in the OP group experienced a more decrease than those in the PO group in severity of Leicester cough scores during the first 4-month of trial. After crossing the groups, the OP group experienced an increase (P = 0.036 and the PO group experienced a nonsignificant decrease (P = 0.104 in the severity of scores. The OP group also experienced improvement in GERD symptoms and quality of life at the end of the trial, but changes in the PO group was not significant. There was no significant change in respiratory function indices in any groups. Conclusion: Long-term treatment with high-dose omeprazole improved GERD as well as cough, and quality of life, but not changed respiratory function indices in sulfur mustard injured cases with respiratory symptoms.

  13. Effect of change in symptoms, respiratory status, nutritional profile and quality of life on response to treatment for advanced non-small cell lung cancer.

    Mohan, Anant; Singh, P; Kumar, S; Mohan, C; Pathak, A K; Pandey, R M; Guleria, R

    2008-01-01

    Quality of life (QOL), and pulmonary and nutritional parameters are important outcome measures during treatment of lung cancer; however, the effect of chemotherapy on these factors and their relationship with clinical response is unclear. Patients with non-small cell lung cancer (NSCLC) were evaluated for symptom profile, nutritional status (using anthropometry), pulmonary functions by spirometry and six minute walk distance (6 MWD), and QOL using the WHO-QOL Bref 26 questionnaire, before and after chemotherapy. Forty-four patients were studied (mean (SD) age, 55 (10) years, 75% males). The majority (98%) had stage III or IV disease and 72% were current / ex-smokers with median pack-years of 27.0 (range, 0.5-90). Some 61% had a Karnofsky Performance Scale (KPS) 70 or 80. The commonest symptoms were coughing, dyspnea, chest pain, anorexia and fever (79%, 72%, 68%, 57% and 40%, respectively). The mean (SD) 6 MWD was 322.5 (132.6) meters. The mean (SD) percentage forced vital capacity (FVC %), and forced expiratory volume in one second (FEV1 %) were 64.7 (18.8) and 57.8 (19.4), respectively. The mean (SD) QOL scores for the physical, psychological, social, and environmental domains were 52.9 (20.5), 56.1 (17.9), 64.5 (21.8), 57.1 (16.6), respectively. Fourteen patients (32%) responded to chemotherapy. Non-responders had significantly higher baseline occurrence of fever, anorexia, and weight loss, higher pack-years of smoking and poorer KPS compared to responders. Overall, chemotherapy caused significant decline in the frequency of coughing, dyspnea, chest pain, fever, anorexia, weight loss, and improvement in hemoglobin and albumin levels. There was no significant improvement in pulmonary functions, nutritional status, or QOL scores after treatment. Lung cancer patients have a poor QOL. Although chemotherapy provides significant symptomatic benefit, this does not translate into similar benefit in respiratory and nutritional status or QOL. Patients with constitutional

  14. Early Exposure to Traffic-Related Air Pollution, Respiratory Symptoms at 4 Years of Age, and Potential Effect Modification by Parental Allergy, Stressful Family Events, and Sex: A Prospective Follow-up Study of the PARIS Birth Cohort.

    Rancière, Fanny; Bougas, Nicolas; Viola, Malika; Momas, Isabelle

    2017-04-01

    The relation between traffic-related air pollution (TRAP) exposure and the incidence of asthma/allergy in preschool children has been widely studied, but results remain heterogeneous, possibly due to differences in methodology and susceptibility to TRAP. We aimed to study the relation of early TRAP exposure with the development of respiratory/allergic symptoms and asthma during preschool years, and to investigate parental allergy, "stressful" family events, and sex as possible effect modifiers. We examined data of 2,015 children from the PARIS birth cohort followed up with repeated questionnaires completed by parents until age 4 years. TRAP exposure in each child's first year of life was estimated by nitrogen oxides (NO x ) air dispersion modeling, taking into account both home and day care locations. Association between TRAP exposure and patterns of wheezing, dry night cough, and rhinitis symptoms was studied using multinomial logistic regression models adjusted for potential confounders. Effect modification by parental history of allergy, stressful family events, and sex was investigated. An interquartile range (26 μg/m 3 ) increase in NO x levels was associated with an increased odds ratio (OR) of persistent wheezing at 4 years (adjusted OR = 1.27; 95% confidence interval: 1.09, 1.47). TRAP exposure was positively associated with persistent wheeze, dry cough, and rhinitis symptoms among children with a parental allergy, those experiencing stressful family events, and boys, but not in children whose parents did not have allergies or experience stressful events, or in girls (all interaction p -values < 0.2). This study supports the hypothesis that not all preschool children are equal regarding TRAP health effects. Parental history of allergy, stressful family events, and male sex may increase their susceptibility to adverse respiratory effects of early TRAP exposure.

  15. Cough Recognition Based on Mel Frequency Cepstral Coefficients and Dynamic Time Warping

    Zhu, Chunmei; Liu, Baojun; Li, Ping

    Cough recognition provides important clinical information for the treatment of many respiratory diseases, but the assessment of cough frequency over a long period of time remains unsatisfied for either clinical or research purpose. In this paper, according to the advantage of dynamic time warping (DTW) and the characteristic of cough recognition, an attempt is made to adapt DTW as the recognition algorithm for cough recognition. The process of cough recognition based on mel frequency cepstral coefficients (MFCC) and DTW is introduced. Experiment results of testing samples from 3 subjects show that acceptable performances of cough recognition are obtained by DTW with a small training set.

  16. Efficacy of face shields against cough aerosol droplets from a cough simulator.

    Lindsley, William G; Noti, John D; Blachere, Francoise M; Szalajda, Jonathan V; Beezhold, Donald H

    2014-01-01

    Health care workers are exposed to potentially infectious airborne particles while providing routine care to coughing patients. However, much is not understood about the behavior of these aerosols and the risks they pose. We used a coughing patient simulator and a breathing worker simulator to investigate the exposure of health care workers to cough aerosol droplets, and to examine the efficacy of face shields in reducing this exposure. Our results showed that 0.9% of the initial burst of aerosol from a cough can be inhaled by a worker 46 cm (18 inches) from the patient. During testing of an influenza-laden cough aerosol with a volume median diameter (VMD) of 8.5 μm, wearing a face shield reduced the inhalational exposure of the worker by 96% in the period immediately after a cough. The face shield also reduced the surface contamination of a respirator by 97%. When a smaller cough aerosol was used (VMD = 3.4 μm), the face shield was less effective, blocking only 68% of the cough and 76% of the surface contamination. In the period from 1 to 30 minutes after a cough, during which the aerosol had dispersed throughout the room and larger particles had settled, the face shield reduced aerosol inhalation by only 23%. Increasing the distance between the patient and worker to 183 cm (72 inches) reduced the exposure to influenza that occurred immediately after a cough by 92%. Our results show that health care workers can inhale infectious airborne particles while treating a coughing patient. Face shields can substantially reduce the short-term exposure of health care workers to large infectious aerosol particles, but smaller particles can remain airborne longer and flow around the face shield more easily to be inhaled. Thus, face shields provide a useful adjunct to respiratory protection for workers caring for patients with respiratory infections. However, they cannot be used as a substitute for respiratory protection when it is needed. [Supplementary materials are

  17. Effect of reducing indoor air pollution on women's respiratory symptoms and lung function: the RESPIRE Randomized Trial, Guatemala.

    Smith-Sivertsen, Tone; Díaz, Esperanza; Pope, Dan; Lie, Rolv T; Díaz, Anaite; McCracken, John; Bakke, Per; Arana, Byron; Smith, Kirk R; Bruce, Nigel

    2009-07-15

    Exposure to household wood smoke from cooking is a risk factor for chronic obstructive lung disease among women in developing countries. The Randomized Exposure Study of Pollution Indoors and Respiratory Effects (RESPIRE) is a randomized intervention trial evaluating the respiratory health effects of reducing indoor air pollution from open cooking fires. A total of 504 rural Mayan women in highland Guatemala aged 15-50 years, all using traditional indoor open fires, were randomized to either receive a chimney woodstove (plancha) or continue using the open fire. Assessments of chronic respiratory symptoms and lung function and individual measurements of carbon monoxide exposure were performed at baseline and every 6 months up to 18 months. Use of a plancha significantly reduced carbon monoxide exposure by 61.6%. For all respiratory symptoms, reductions in risk were observed in the plancha group during follow-up; the reduction was statistically significant for wheeze (relative risk = 0.42, 95% confidence interval: 0.25, 0.70). The number of respiratory symptoms reported by the women at each follow-up point was also significantly reduced by the plancha (odds ratio = 0.7, 95% confidence interval: 0.50, 0.97). However, no significant effects on lung function were found after 12-18 months. Reducing indoor air pollution from household biomass burning may relieve symptoms consistent with chronic respiratory tract irritation.

  18. Help-seeking and antibiotic prescribing for acute cough in a Chinese primary care population: a prospective multicentre observational study.

    Wong, Carmen Ka Man; Liu, Zhaomin; Butler, Chris C; Wong, Samuel Yeung Shan; Fung, Alice; Chan, Dicken; Yip, Benjamin Hon Kei; Kung, Kenny

    2016-01-21

    Acute cough is a common reason to prescribe antibiotics in primary care. This study aimed to explore help-seeking and antibiotic prescribing for acute cough in Chinese primary care population. This is a prospective multicentre observational study that included adults presenting with acute cough. Clinicians recorded patients' presenting symptoms, examination findings and medication prescription. Patients completed symptom diaries for up to 28 days by charting their symptom severity and recovery. Adjusted binary logistic regression models identified factors independently associated with antibiotic prescription. Primary care clinicians (n=19) recruited 455 patients. A total of 321 patients (70.5%) returned their completed symptom diaries. Concern about illness severity (41.6%) and obtaining a prescription for symptomatic medications (45.9%), rather than obtaining a prescription for antibiotics, were the main reasons for consulting. Antibiotics were prescribed for 6.8% (n=31) of patients, of which amoxicillin was the most common antimicrobial prescribed (61.3%), as it was associated with clinicians' perception of benefit from antibiotic treatment (odds ratio (OR): 25.9, 95% confidence interval (CI): 6.7-101.1), patients' expectation for antibiotics (OR: 5.1, 95% CI: 1.7-11.6), anticipation (OR: 5.1, 95% CI: 1.6-15.0) and request for antibiotics (OR 15.7, 95% CI: 5.0-49.4), as well as the severity of respiratory symptoms (cough, sputum, short of breath and wheeze OR: 2.7-3.7, all Pantibiotic prescription rates between private primary care clinicians and public primary care clinicians (17.4 vs 1.6%, P=0.00). Symptomatic medication was prescribed in 98.0% of patients. Mean recovery was 9 days for cough and 10 days for all symptoms, which was not significantly associated with antibiotic treatment. Although overall antibiotic-prescribing rates were low, there was a higher rate of antibiotic prescribing among private primary care clinicians, which warrants further

  19. Qualidade do ar interior e sintomas respiratórios em escolas do Porto Indoor air quality and respiratory symptoms in Porto schools

    Sílvia Fraga

    2008-07-01

    Porto schools. Questionnaires were distributed to 9 classes of 7th , 8th and 9th year students in each school, total 1607 adolescents, with a mean age of 14.0 years (standard deviation=0.3. Information was collected on participants’ socio-demographic and social characteristics, behaviour, and housing conditions. The International Study of Asthma and Allergies in Childhood (ISAAC questionnaire was used to evaluate respiratory symptoms. Results: 5.8% of participants stated they had had asthma, 9.2% wheezing, 22.0% sneezing and 6.6% itchy rash In the 12 months preceding the evaluation. After adjustment for parental educational attainment level, CO2 > 2100ppm values were associated with exercise-induced wheeze [OR=1.86 (95%CI:1.20-2.89] and night cough [OR=1.40 (4.20-2.89]. We observed an increasing odds ratio in wheezing symptoms over the last 12 months, in asthma ‘at some point’ and asthma over the last 12 months, and night cough at schools with higher VOC values. The association was not statistically significant, however. Conclusion: Lower indicators of indoor air quality, particularly CO2, were associated with a greater respiratory symptomatology.

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

    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...

  1. Baclofen vs. Dextromethorphan in the treatment of coughing: a randomized clinical trial

    Shahriar M

    2010-01-01

    Full Text Available "n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Cough is one of the most common symptoms for which outpatient care is sought. Since, a few research evaluated efficacy and therapeutic effect of baclofen in remedy of cough (especially chronic cough, In this study we compared the efficacy of oral Baclofen 20 mg with Dextromethorphan to improvement of cough in two groups."n"nMethods: In this double blind randomized clinical trial, 120 patients with chronic cough (up to three weeks that were referred to respiratory diseases clinic of Ali Ebn-e Abitaleb (AS hospital in Zahedan, Iran at 2007 were randomly devided to two groups. 60 peoples in each, (baclofen recipient group with mean age 32.32±6.51 and dextromethorphan recipient group with mean age 31.54±5.06 year were evaluated for qualitative decline of severity, period and duration of cough for 14 days. "n"nResults: In baclofen recipient group 73.3% and in dextromethorphan recipient group 65% all patients had decline of severity, period and duration of the cough. Statistically, there were no significant differences between two groups in regard to qualitative decline of severity, period and duration of cough (p>0.05. Also, there were no drug related side effects in the patients."n"nConclusions: Baclofen

  2. Impact of current cough on health-related quality of life in patients with COPD

    Deslee G

    2016-09-01

    [FEV1]: 57 [37–72] % predicted (median [Q1–Q3]. In univariate analyses, health-related quality of life (Saint George’s respiratory questionnaire total score was associated with each CASA-Q domain and with chronic bronchitis, exacerbations, dyspnea, FEV1, depression, and anxiety. All four domains introduced separately were independently associated with health-related quality of life. When introduced together in multivariate analyses, only the cough impact domain remained independently associated with health-related quality of life (R2=0.60. With chronic bronchitis (standard definition instead of the CASA-Q, the R2 was lower (R2=0.54.Conclusion: This study provides evidence that current cough in the previous 7 days is an important determinant of health-related quality of life impairment in stable COPD patients.Keywords: signs and symptoms, respiratory, sputum, questionnaires, dyspnea, multivariate analysis

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

    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.

  4. Short-term exposure to high ambient air pollution increases airway inflammation and respiratory symptoms in chronic obstructive pulmonary disease patients in Beijing, China.

    Wu, Shaowei; Ni, Yang; Li, Hongyu; Pan, Lu; Yang, Di; Baccarelli, Andrea A; Deng, Furong; Chen, Yahong; Shima, Masayuki; Guo, Xinbiao

    2016-09-01

    Few studies have investigated the short-term respiratory effects of ambient air pollution in chronic obstructive pulmonary disease (COPD) patients in the context of high pollution levels in Asian cities. A panel of 23 stable COPD patients was repeatedly measured for biomarkers of airway inflammation including exhaled nitric oxide (FeNO) and exhaled hydrogen sulfide (FeH2S) (215 measurements) and recorded for daily respiratory symptoms (794person-days) in two study periods in Beijing, China in January-September 2014. Daily ambient air pollution data were obtained from nearby central air-monitoring stations. Mixed-effects models were used to estimate the associations between exposures and health measurements with adjustment for potential confounders including temperature and relative humidity. Increasing levels of air pollutants were associated with significant increases in both FeNO and FeH2S. Interquartile range (IQR) increases in PM2.5 (76.5μg/m(3), 5-day), PM10 (75.0μg/m(3), 5-day) and SO2 (45.7μg/m(3), 6-day) were associated with maximum increases in FeNO of 13.6% (95% CI: 4.8%, 23.2%), 9.2% (95% CI: 2.1%, 16.8%) and 34.2% (95% CI: 17.3%, 53.4%), respectively; and the same IQR increases in PM2.5 (6-day), PM10 (6-day) and SO2 (7-day) were associated with maximum increases in FeH2S of 11.4% (95% CI: 4.6%, 18.6%), 7.8% (95% CI: 2.3%, 13.7%) and 18.1% (95% CI: 5.5%, 32.2%), respectively. Increasing levels of air pollutants were also associated with increased odds ratios of sore throat, cough, sputum, wheeze and dyspnea. FeH2S may serve as a novel biomarker to detect adverse respiratory effects of air pollution. Our results provide potential important public health implications that ambient air pollution may pose risk to respiratory health in the context of high pollution levels in densely-populated cities in the developing world. Copyright © 2016 Elsevier Ltd. All rights reserved.

  5. Connections between voice ergonomic risk factors and voice symptoms, voice handicap, and respiratory tract diseases.

    Rantala, Leena M; Hakala, Suvi J; Holmqvist, Sofia; Sala, Eeva

    2012-11-01

    The aim of the study was to investigate the connections between voice ergonomic risk factors found in classrooms and voice-related problems in teachers. Voice ergonomic assessment was performed in 39 classrooms in 14 elementary schools by means of a Voice Ergonomic Assessment in Work Environment--Handbook and Checklist. The voice ergonomic risk factors assessed included working culture, noise, indoor air quality, working posture, stress, and access to a sound amplifier. Teachers from the above-mentioned classrooms reported their voice symptoms, respiratory tract diseases, and completed a Voice Handicap Index (VHI). The more voice ergonomic risk factors found in the classroom the higher were the teachers' total scores on voice symptoms and VHI. Stress was the factor that correlated most strongly with voice symptoms. Poor indoor air quality increased the occurrence of laryngitis. Voice ergonomics were poor in the classrooms studied and voice ergonomic risk factors affected the voice. It is important to convey information on voice ergonomics to education administrators and those responsible for school planning and taking care of school buildings. Copyright © 2012 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

  6. Preventing Pertussis (Whooping Cough)

    ... causes a whooping sound. They may gag on mucus and throw up after they cough. Not every ... your baby through the placenta and your breast milk. Your baby can get protection from pertussis for ...

  7. Whooping Cough PSA (:30)

    This 30 second PSA encourages pregnant women to get the whooping cough vaccine, called Tdap, during the third trimester of each pregnancy in order to pass antibodies to their babies so they are born with protection against this serious disease.

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

    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.

  9. Sources of household air pollution: The association with lung function and respiratory symptoms in middle-aged adult.

    Devien, Laurent; Giovannelli, Jonathan; Cuny, Damien; Matran, Régis; Amouyel, Philippe; Hulo, Sébastien; Edmé, Jean Louis; Dauchet, Luc

    2018-07-01

    The objective of the present study was to investigate the relationship between sources of household air pollution, respiratory symptoms and lung function. 3039 adults aged from 40 to 65 participated in the 2011-2013 ELISABET cross-sectional survey in northern France. Lung function was measured using spirometry. During a structured interview, respiratory symptoms, household fuels, exposure to moulds, and use of ventilation were recorded on a questionnaire. The self-reported presence of mould in at least two rooms (not including the bathroom and the kitchen) was associated with a 2.5% lower predicted forced expiratory volume in 1 s (95% confidence interval, -4.7 to -0.29; p-trend respiratory disease. Our results suggest that the presence of mould (known to be associated with more severe asthma symptoms) could also have an impact on respiratory symptoms and lung function in the general population and in populations without known respiratory disease. Copyright © 2018 Elsevier Inc. All rights reserved.

  10. Role of patients' and doctors' views on the management of respiratory tract infections

    Duijn, Huig Jacob van

    2006-01-01

    The vast majority of respiratory tract (RT) symptoms such as cough, sore throat and earache are self-limiting (viral) infections. Despite this self-limiting character, in the Netherlands antibiotics are prescribed in about one out of every three RT episodes. A further rationalisation of antibiotic

  11. Associations between pesticide use and respiratory symptoms: A cross-sectional study in Southern Ghana

    Quansah, Reginald, E-mail: reginald.quansah@ug.edu.gh [Biological, Environmental & Occupational Health Sciences, School of Public Health, College of Health Sciences, University of Ghana, Legon, Accra (Ghana); Department of Immunology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Accra (Ghana); Bend, John R. [Department of Pathology & Laboratory Medicine, Siebens-Drake Medical Research Institute, Schulich School of Medicine & Dentistry, Western University, London (Canada); Abdul-Rahaman, Abukari [Biological, Environmental & Occupational Health Sciences, School of Public Health, College of Health Sciences, University of Ghana, Legon, Accra (Ghana); Armah, Frederick Ato [Department of Environmental Science, School of Biological Sciences, College of Agriculture & Natural Sciences, University of Cape Coast, Cape Coast (Ghana); Luginaah, Isaac [Department of Geography, Western University, Ontario (Canada); Essumang, David Kofi [Environmental Health Group, Department of Chemistry, University of Cape Coast, Cape Coast (Ghana); Iddi, Samuel [Department of Statistics, University of Ghana, Legon, Accra (Ghana); Chevrier, Jonathan [Department of Epidemiology, Biostatistics and Occupational Health McGill University, Montréal, Québec (Canada); Cobbina, Samuel Jerry [Department of Ecotourism and Environmental Management, Faculty of Renewable Natural Resources, University for Development Studies, Nyankpala (Ghana); Nketiah-Amponsah, Edward [Department of Economics, University of Ghana, Legon (Ghana); Adu-Kumi, Samuel [Chemicals Control and Management Centre, Environmental Protection Agency, Accra (Ghana); Darko, Godfred [Department of Chemistry, Kwame Nkrumah University of Science and Technology, Kumasi (Ghana); Afful, Samuel [Nuclear Chemistry and Environmental Research Centre, Ghana Atomic Energy Commission, Accra (Ghana)

    2016-10-15

    Background: Indiscriminate use of pesticides is a common practice amongst farmers in Low and Middle Income Countries (LMIC) across the globe. However, there is little evidence defining whether pesticide use is associated with respiratory symptoms. Objectives: This cross-sectional study was conducted with 300 vegetable farmers in southern Ghana (Akumadan). Data on pesticide use was collected with an interviewed-administered questionnaire. The concentration of seven organochlorine pesticides and 3 pyrethroid pesticides was assayed in urine collected from a sub-population of 100 vegetable farmers by a gas chromatograph equipped with an electron capture detector (GC-ECD). Results: A statistically significant exposure-response relationship of years per day spent mixing/applying fumigant with wheezing [30–60 days/year: prevalence ratio (PR)=1.80 (95% CI 1.30, 2.50); >60days/year: 3.25 (1.70–6.33), p for trend=0.003] and hours per day spent mixing/applying fumigant with wheezing [1–2 h/day: 1.20 (1.02–1.41), 3–5 h/day: 1.45 (1.05–1.99), >5 h/day: 1.74 (1.07–2.81), p for trend=0.0225]; days per year spent mixing/applying fungicide with wheezing [30–60 days/year: 2.04 (1.31–3.17); >60days/year: 4.16 (1.72–10.08), p for trend=0.0017] and h per day spent mixing/applying fungicide with phlegm production [1–2 h/day: 1.25 (1.05–1.47), 3–5 h/day: 1.55 (1.11–2.17), >5 h/day: 1.93 (1.17–3.19), p for trend=0.0028] and with wheezing [1–2 h/day: 1.10 (1.00–1.50), 3–5 h/day: 1.20 (1.11–1.72), >5 h/day: 1.32 (1.09–2.53), p for trend=0.0088]; h per day spent mixing/applying insecticide with phlegm production [1–2 h/day: 1.23 (1.09–1.62), 3–5 h/day: 1.51 (1.20–2.58), >5 h/day: 1.85 (1.31–4.15), p for trend=0.0387] and wheezing [1–2 h/day: 1.22 (1.02–1.46), 3–5 h/day: 1.49 (1.04–2.12), >5 h/day: 1.81 (1.07–3.08), p for trend=0.0185] were observed. Statistically significant exposure-response association was also observed for a

  12. Associations between pesticide use and respiratory symptoms: A cross-sectional study in Southern Ghana

    Quansah, Reginald; Bend, John R.; Abdul-Rahaman, Abukari; Armah, Frederick Ato; Luginaah, Isaac; Essumang, David Kofi; Iddi, Samuel; Chevrier, Jonathan; Cobbina, Samuel Jerry; Nketiah-Amponsah, Edward; Adu-Kumi, Samuel; Darko, Godfred; Afful, Samuel

    2016-01-01

    Background: Indiscriminate use of pesticides is a common practice amongst farmers in Low and Middle Income Countries (LMIC) across the globe. However, there is little evidence defining whether pesticide use is associated with respiratory symptoms. Objectives: This cross-sectional study was conducted with 300 vegetable farmers in southern Ghana (Akumadan). Data on pesticide use was collected with an interviewed-administered questionnaire. The concentration of seven organochlorine pesticides and 3 pyrethroid pesticides was assayed in urine collected from a sub-population of 100 vegetable farmers by a gas chromatograph equipped with an electron capture detector (GC-ECD). Results: A statistically significant exposure-response relationship of years per day spent mixing/applying fumigant with wheezing [30–60 days/year: prevalence ratio (PR)=1.80 (95% CI 1.30, 2.50); >60days/year: 3.25 (1.70–6.33), p for trend=0.003] and hours per day spent mixing/applying fumigant with wheezing [1–2 h/day: 1.20 (1.02–1.41), 3–5 h/day: 1.45 (1.05–1.99), >5 h/day: 1.74 (1.07–2.81), p for trend=0.0225]; days per year spent mixing/applying fungicide with wheezing [30–60 days/year: 2.04 (1.31–3.17); >60days/year: 4.16 (1.72–10.08), p for trend=0.0017] and h per day spent mixing/applying fungicide with phlegm production [1–2 h/day: 1.25 (1.05–1.47), 3–5 h/day: 1.55 (1.11–2.17), >5 h/day: 1.93 (1.17–3.19), p for trend=0.0028] and with wheezing [1–2 h/day: 1.10 (1.00–1.50), 3–5 h/day: 1.20 (1.11–1.72), >5 h/day: 1.32 (1.09–2.53), p for trend=0.0088]; h per day spent mixing/applying insecticide with phlegm production [1–2 h/day: 1.23 (1.09–1.62), 3–5 h/day: 1.51 (1.20–2.58), >5 h/day: 1.85 (1.31–4.15), p for trend=0.0387] and wheezing [1–2 h/day: 1.22 (1.02–1.46), 3–5 h/day: 1.49 (1.04–2.12), >5 h/day: 1.81 (1.07–3.08), p for trend=0.0185] were observed. Statistically significant exposure-response association was also observed for a

  13. Mucosal immunity and upper respiratory tract symptoms in recreational endurance runners.

    Ihalainen, Johanna K; Schumann, Moritz; Häkkinen, Keijo; Mero, Antti A

    2016-01-01

    The present study investigated the effects of a 12-week endurance-training intervention on salivary proteins and upper respiratory tract symptoms (URS) in 25 young men. Saliva samples of 25 recreational male endurance runners (age 34.6 years, body mass index = 23.8 kg·m(-2), peak aerobic capacity = 47.2 mL·kg(-1)·min(-1)) were collected before (PRE) and after (POST) the training intervention, in a fasting state, as well as both before and after a maximal incremental treadmill run. The training consisted of both continuous and interval training sessions, 4-6 times per week based on the polarized training approach. Participants filled in Wisconsin Upper Respiratory Symptom Survey-21 and were retrospectively divided into 2 groups according to whether they reported URS (URS group, n = 13) or not (HEALTHY group, n = 12). Basal salivary immunoglobulin A (sa-sIgA) levels were significantly higher (+70%, p < 0.05) in the HEALTHY group both at PRE and POST whereas no significant differences were observed in salivary immunoglobulin M, salivary immunoglobulin G, lysozyme, or salivary α-amylase activity (sAA). Sa-sIgA concentration at PRE significantly correlated with the number of sick-days (R = -0.755, p < 0.001) in all subjects. The incremental treadmill run acutely increased sAA significantly (p < 0.05) at PRE (200%) and POST (166%) in the HEALTHY group but not in the URS group. This study demonstrated that subjects, who experienced URS during the 12 weeks of progressive endurance training intervention, had significantly lower basal sa-sIgA levels both before and after the experimental endurance training period. In addition to sa-sIgA, acute sAA response to exercise might be a possible determinant of susceptibility to URS in endurance runners.

  14. Critical age windows in the impact of lifetime smoking exposure on respiratory symptoms and disease among ever smokers.

    Erbas, Bircan; Knudsen, Toril Mørkve; Janson, Christer; Nilsen, Roy M; Accordini, Simone; Benediktdottir, Bryndis; Dratva, Julia; Heinrich, Joachim; Jarvis, Debbie; Leynaert, Benedcite; Matheson, Melanie C; Norbäck, Dan; Real, Francisco G; Raherison-Semjen, Chantal; Villani, Simona; Dharmage, S C; Svanes, C

    2018-07-01

    Despite extensive knowledge of smoking effects on respiratory disease, there is no study including all age windows of exposure among ever smokers. The objective of this study was to assess the effects from smoking exposure in utero, early childhood, adolescence and adulthood on respiratory health outcomes in adult male and female ever smokers. Respiratory health outcomes were assessed in 10,610 participants of the European Community Respiratory Health Survey (ECRHS) I who reported a history of ever smoking by questionnaire. The associations of maternal smoking in utero, maternal smoking during childhood, age of smoking debut and pack-years of smoking with respiratory symptoms, obstructive diseases and bronchial hyperreactivity were analysed using generalized linear regression, non-linearity between age of smoking debut and outcomes were assessed by Generalized additive mixed models. Respiratory symptoms and asthma were more frequent in adults if their mother smoked during pregnancy, and, in men, also if mother smoked in childhood. Wheeze and ≥3 respiratory symptoms declined with later smoking debut among women [≤10 years: OR = 3.51, 95% CI 1.26, 9.73; 11-12 years: 1.57[1.01-2.44]; 13-15 years: 1.11[0.94-1.32] and ≤10 years: 3.74[1.56-8.83]; 11-12 years: 1.76[1.19-2.56]; 13-15 years: 1.12[0.94-1.35], respectively]. Effects of increasing number of packyears were pronounced in women (Chronic Obstructive Pulmonary Disease (COPD): OR/10 packyears women: 1.33 [1.18, 1.50], men: 1.14 [1.04, 1.26] p interaction = 0.01). Among ever smokers, smoking exposure in each stage of the lifespan show persistent harmful effects for adult respiratory health, while women appeared to be more vulnerable to an early age of smoking debut and amount of smoking in adulthood. Copyright © 2018. Published by Elsevier Inc.

  15. A Whooping Cough Education Module for WIC Clients in Utah.

    Luthy, Karlen E; Anderson, Alicia; Macintosh, Janelle; Beckstrand, Renea L; Eden, Lacey M; Amy, Ryan; Macintosh, Christopher I

    Clients in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) are required to complete education modules quarterly to maintain eligibility. The purposes of this project were to: (1) create a whooping cough vaccination education module for WIC clients; (2) evaluate baseline perceptions of WIC clients on the whooping cough vaccine and disease; and (3) evaluate whooping cough knowledge following completion of the module. A decline in vaccination rates among infants and children using WIC services was reported by a local WIC program director who requested whooping cough vaccination education materials. This quality improvement project included development of a whooping cough education module and evaluation of learning. Learning was evaluated using a pre- and posttest design. Client feedback was solicited via open-ended questions. Quantitative analysis was performed on visual analog-type questions with paired t-tests and a Cohen's d. Content analysis was conducted on open-ended items. The module was designed by a team of vaccination experts and included general definitions, signs and symptoms during the three stages of disease, recommendations to prevent whooping cough, and vaccination recommendations. Learning of users of the module was then evaluated. After using the module, clients indicated they were significantly more likely to vaccinate themselves and their child against whooping cough, and to recommend the vaccination to their family members. The greatest concern of participants about whooping cough was how it affected infants. Participants reported they learned new information on disease seriousness, recognition of symptoms, and treatment options but still requested additional information on the whooping cough disease and vaccine. A whooping cough education module is an effective strategy to improve whooping cough knowledge and promote the whooping cough vaccine.

  16. Consumer attitudes on cough and cold: US (ACHOO) survey results.

    Blaiss, M S; Dicpinigaitis, P V; Eccles, R; Wingertzahn, M A

    2015-08-01

    The Attitudes of Consumers Toward Health, Cough, and Cold (ACHOO) survey was developed to better inform health care providers on the natural history and impact of common cold and cough, and related consumer experience and behaviors. Randomly selected US Internet/mobile device users were invited to participate in an online survey (N = 3333) in October 2012. Response quotas modeled upon 2010 US Census data ensured a demographically representative sample. To reduce potential bias from the quota design, 75% of the completed surveys were randomly selected as the primary analysis pool. Survey questions assessed participant demographics, frequency and duration of cough/cold symptoms, impact of symptoms on daily life, treatment preferences, and knowledge about cough/cold pathophysiology. In the past year, 84.6% of respondents had experienced at least one cold. Colds typically started with sore/scratchy throat (39.2%), nasal congestion (9.8%), and runny nose (9.3%) and lasted 3-7 days. Cough, the most common cold symptom (73.1%), had a delayed onset (typically 1-5 days after cold onset) and a long duration (>6 days in 35.2%). Nasal congestion and cough were the most bothersome symptoms. Many respondents waited until symptoms were 'bad enough' (42.6%) or multiple symptoms were present (20.2%) before using nonprescription medications. Drivers of choice included effectiveness in relieving symptoms, safety, and past experience. Respondents rarely consulted clinicians regarding treatment, and more than three-quarters had never received instructions from a clinician on how to choose a nonprescription cough/cold medication. Misperceptions regarding etiology and treatment of the common cold were prevalent. The main limitation is potential recall bias, since respondents had to recall cough/cold episodes over the prior year. The ACHOO survey confirms that cold is a common, bothersome experience and that there are gaps in consumers' knowledge of pathophysiology and appropriate

  17. Human Syngamosis as an Uncommon Cause of Chronic Cough

    Pulcherio, Janaína Oliveira Bentivi

    2013-09-01

    Full Text Available Introduction: Chronic cough may represent a diagnostic challenge. Chronic parasitism of upper airways is an unusual cause. Objective: To describe a case of human syngamosis as an uncommon cause of dry cough. Case Report: An endoscopic exam performed in a woman suffering of chronic cough revealed a Y-shaped worm in the larynx identified as Syngamus laryngeus. Discussion: This nematode parasitizes the upper respiratory tract of many animals including humans. The diagnosis is performed by the examination of the worm expelled by cough or by endoscopy. Endoscopic exam is easy to perform and is essential in the diagnosis of causes of chronic cough, even uncommon entities. Removal is the only efficient treatment.

  18. Automatic cough episode detection using a vibroacoustic sensor.

    Mlynczak, Marcel; Pariaszewska, Katarzyna; Cybulski, Gerard

    2015-08-01

    Cough monitoring is an important element of the diagnostics of respiratory diseases. The European Respiratory Society recommends objective assessment of cough episodes and the search for methods of automatic analysis to make obtaining the quantitative parameters possible. The cough "events" could be classified by a microphone and a sensor that measures the vibrations of the chest. Analysis of the recorded signals consists of calculating the features vectors for selected episodes and of performing automatic classification using them. The aim of the study was to assess the accuracy of classification based on an artificial neural networks using vibroacoustic signals collected from chest. Six healthy, young men and eight healthy, young women carried out an imitated cough, hand clapping, speech and shouting. Three methods of parametrization were used to prepare the vectors of episode features - time domain, time-frequency domain and spectral modeling. We obtained the accuracy of 95% using artificial neural networks.

  19. Rhinovirus-induced VP1-specific Antibodies are Group-specific and Associated With Severity of Respiratory Symptoms

    Katarzyna Niespodziana

    2015-01-01

    Interpretation: Our results demonstrate that increases of antibodies towards the VP1 N-terminus are group-specific and associated with severity of respiratory symptoms and suggest that it may be possible to develop serological tests for identifying causative RV groups.

  20. Chronic and acute exposures to the world trade center disaster and lower respiratory symptoms: area residents and workers.

    Maslow, Carey B; Friedman, Stephen M; Pillai, Parul S; Reibman, Joan; Berger, Kenneth I; Goldring, Roberta; Stellman, Steven D; Farfel, Mark

    2012-06-01

    We assessed associations between new-onset (post-September 11, 2001 [9/11]) lower respiratory symptoms reported on 2 surveys, administered 3 years apart, and acute and chronic 9/11-related exposures among New York City World Trade Center-area residents and workers enrolled in the World Trade Center Health Registry. World Trade Center-area residents and workers were categorized as case participants or control participants on the basis of lower respiratory symptoms reported in surveys administered 2 to 3 and 5 to 6 years after 9/11. We created composite exposure scales after principal components analyses of detailed exposure histories obtained during face-to-face interviews. We used multivariate logistic regression models to determine associations between lower respiratory symptoms and composite exposure scales. Both acute and chronic exposures to the events of 9/11 were independently associated, often in a dose-dependent manner, with lower respiratory symptoms among individuals who lived and worked in the area of the World Trade Center. Study findings argue for detailed assessments of exposure during and after events in the future from which potentially toxic materials may be released and for rapid interventions to minimize exposures and screen for potential adverse health effects.

  1. Respiratory symptoms in the first 7 years of life and birth weight at term - The PIAMA birth cohort

    Caudri, Daan; Wijga, Alet; Gehring, Ulrike; Smit, Henriette A.; Brunekreef, Bert; Kerkhof, Marjan; Hoekstra, Maarten; Gerritsen, Jorrit; de Jongste, Johan C.

    2007-01-01

    Rationale: The relation between birth weight and respiratory symptoms and asthma in children remains unclear. Previous studies focused on a relation at separate ages. A longitudinal analysis may lead to a better understanding. Objectives: To estimate the effect of birth weight on the development and

  2. RELATIONSHIP OF AIRWAY HYPERRESPONSIVENESS TO RESPIRATORY SYMPTOMS AND DIURNAL PEAK FLOW VARIATION IN PATIENTS WITH OBSTRUCTIVE LUNG-DISEASE

    BRAND, PLP; POSTMA, DS; KERSTJENS, HAM; KOETER, GH

    This study reports on the relationship of airway hyperresponsiveness (AH) with respiratory symptoms and diurnal peak flow expiratory (PEF) variation in 221 hyperresponsive patients with moderately severe airways obstruction. The disease was in a stable phase in all patients. Closely adhering to the

  3. Relation of the Timing of Onset of Rhinitis and Cough to Asthma Attack in Children.

    Sugimura, Tetsu; Ozaki, Yukiko; Tananari, Yoshifumi; Yamakawa, Rumi; Hirata, Rumiko

    2016-01-01

    If the risk of progression to asthma could be predicted in patients with rhinitis, prevention of asthma might become possible. The purpose of this study was to clarify the relationship between the duration of rhinitis symptoms and acute asthma attacks in children with a history of asthma who were not on treatment for asthma. In 94 children with a history of asthma who were asymptomatic after completing asthma treatment, we investigated the onset and duration of nasal discharge and cough related to allergic rhinitis. Then the children were followed up for 2 weeks and were classified into either an asthma attack group (Group A) or non-asthma group(Group B). A total of 78 subjects were evaluated after 16 were excluded. The duration of nasal discharge was significantly shorter in Group A than in Group B (5.5±1.9 days vs. 10.4±3.1 days, Pasthma attack may be higher when the onset of cough precedes nasal discharge or when nasal discharge has a short duration and cough shows an early onset. These results may provide assistance when selecting patients for early anti-allergy therapy from among those presenting with upper respiratory tract symptoms.

  4. Evaluation of a Web-based intervention providing tailored advice for self-management of minor respiratory symptoms: exploratory randomized controlled trial.

    Yardley, Lucy; Joseph, Judith; Michie, Susan; Weal, Mark; Wills, Gary; Little, Paul

    2010-12-15

    There has been relatively little research on the role of web-based support for self-care in the management of minor, acute symptoms, in contrast to the wealth of recent research into Internet interventions to support self-management of long-term conditions. This study was designed as an evaluation of the usage and effects of the "Internet Doctor" website providing tailored advice on self-management of minor respiratory symptoms (eg, cough, sore throat, fever, runny nose), in preparation for a definitive trial of clinical effectiveness. The first aim was to evaluate the effects of using the Internet Doctor webpages on patient enablement and use of health services, to test whether the tailored, theory-based advice provided by the Internet Doctor was superior to providing a static webpage providing the best existing patient information (the control condition). The second aim was to gain an understanding of the processes that might mediate any change in intentions to consult the doctor, by comparing changes in relevant beliefs and illness perceptions in the intervention and control groups, and by analyzing usage of the Internet Doctor webpages and predictors of intention change. Participants (N = 714) completed baseline measures of beliefs about their symptoms and self-care online, and were then automatically randomized to the Internet Doctor or control group. These measures were completed again by 332 participants after 48 hours. Four weeks later, 214 participants completed measures of enablement and health service use. The Internet Doctor resulted in higher levels of satisfaction than the control information (mean 6.58 and 5.86, respectively; P = .002) and resulted in higher levels of enablement a month later (median 3 and 2, respectively; P = .03). Understanding of illness improved in the 48 hours following use of the Internet Doctor webpages, whereas it did not improve in the control group (mean change from baseline 0.21 and -0.06, respectively, P = .05). Decline

  5. Fractional exhaled nitric oxide as a predictor of response to inhaled corticosteroids in patients with non-specific respiratory symptoms and insignificant bronchodilator reversibility

    Price, David B; Buhl, Roland; Chan, Adrian

    2018-01-01

    BACKGROUND: Chronic non-specific respiratory symptoms are difficult to manage. This trial aimed to evaluate the association between baseline fractional exhaled nitric oxide (FeNO) and the response to inhaled corticosteroids in patients with non-specific respiratory symptoms. METHODS: In this doub...

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

    Anne Kotaniemi-Syrjänen

    2008-04-01

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

  7. Antibiotics for whooping cough (pertussis).

    Altunaiji, S; Kukuruzovic, R; Curtis, N; Massie, J

    2007-07-18

    Whooping cough is a highly contagious disease. Infants are at highest risk of severe disease and death. Erythromycin for 14 days is currently recommended for treatment and contact prophylaxis, but is of uncertain benefit. To study the benefits and risks of antibiotic treatment of and contact prophylaxis against whooping cough. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), the Database of Abstracts of Reviews of Effects (DARE) (The Cochrane Library Issue 1, 2007); MEDLINE (January 1966 to March 2007); EMBASE (January 1974 to March 2007). All randomised and quasi-randomised controlled trials of antibiotics for treatment of, and contact prophylaxis against, whooping cough. Three to four review authors independently extracted data and assessed the quality of each trial. Thirteen trials with 2197 participants met the inclusion criteria: 11 trials investigated treatment regimens; 2 investigated prophylaxis regimens. The quality of the trials was variable.Short-term antibiotics (azithromycin for three to five days, or clarithromycin or erythromycin for seven days) were as effective as long-term (erythromycin for 10 to 14 days) in eradicating Bordetella pertussis (B. pertussis) from the nasopharynx (relative risk (RR) 1.02, 95% confidence interval (CI) 0.98 to 1.05), but had fewer side effects (RR 0.66, 95% CI 0.52 to 0.83). Trimethoprim/sulfamethoxazole for seven days was also effective. Nor were there differences in clinical outcomes or microbiological relapse between short and long-term antibiotics. Contact prophylaxis of contacts older than six months of age with antibiotics did not significantly improve clinical symptoms or the number of cases developing culture-positive B. pertussis. Although antibiotics were effective in eliminating B. pertussis, they did not alter the subsequent clinical course of the illness. There is insufficient evidence to determine the benefit of prophylactic treatment of pertussis contacts.

  8. Indoor risk factors for cough and their relation to wheeze and sensitization in Chilean young adults.

    Potts, James F; Rona, Roberto J; Oyarzun, Manuel J; Amigo, Hugo; Bustos, Patricia

    2008-04-01

    We assessed the effects of indoor risk factors, including smoking, on different types of cough and on cough and wheeze in combination. Our sample was composed of 1232 men and women residing in a semirural area of Chile. We used a standardized questionnaire, sensitization to 8 allergens, and bronchial hyperresponsiveness to methacholine to assess cough and wheeze characteristics. Information was gathered on dampness, mold, ventilation, heating, housing quality, smoking, and environmental tobacco smoke exposure. Most exposures were associated with cough alone or cough in combination with wheeze. Smoking, past smoking, and environmental tobacco smoke exposure were strongly associated with dry cough and wheeze. The use of coal for heating was associated with dry cough. Leaks, mold, and lack of kitchen ventilation were associated with cough and wheeze. Nocturnal cough and productive cough were associated with specific types of sensitization, but dry cough was not. Productive cough was associated with hyperresponsiveness to methacholine. Several different types of indoor exposures, including environmental tobacco smoke exposure, are important contributors to morbidity associated with cough and wheeze. A vigorous preventive strategy designed to lower exposures to indoor risk factors would lower rates of respiratory morbidity.

  9. Indoor risk factors for cough and their relation to wheeze and sensitization in Chilean young adults

    Potts, J.F.; Rona, R.J.; Oyarzun, M.J.; Amigo, H.; Bustos, P. [Kings College London, London (United Kingdom). Dept. for Public Health Science

    2008-04-15

    We assessed the effects of indoor risk factors, including smoking, on different types of cough and on cough and wheeze in combination. Our sample was composed of 1232 men and women residing in a semi-rural area of Chile. We used a standardized questionnaire, sensitization to 8 allergens, and bronchial hyperresponsiveness to methacholine to assess cough and wheeze characteristics. Information was gathered on dampness, mold, ventilation, heating, housing quality, smoking, and environmental tobacco smoke exposure. Most exposures were associated with cough alone or cough in combination with wheeze. Smoking, past smoking, and environmental tobacco smoke exposure were strongly associated with dry cough and wheeze. The use of coal for heating was associated with dry cough. Leaks, mold, and lack of kitchen ventilation were associated with cough and wheeze. Nocturnal cough and productive cough were associated with specific types of sensitization, but dry cough was not. Productive cough was associated with hyperresponsiveness to methacholine. Several different types of indoor exposures, including environmental tobacco smoke exposure, are important contributors to morbidity associated with cough and wheeze. A vigorous preventive strategy designed to lower exposures to indoor risk factors would lower rates of respiratory morbidity.

  10. Indoor Risk Factors for Cough and Their Relation to Wheeze and Sensitization in Chilean Young Adults

    Potts, James F.; Rona, Roberto J.; Oyarzun, Manuel J.; Amigo, Hugo; Bustos, Patricia

    2008-01-01

    Objectives. We assessed the effects of indoor risk factors, including smoking, on different types of cough and on cough and wheeze in combination. Methods. Our sample was composed of 1232 men and women residing in a semirural area of Chile. We used a standardized questionnaire, sensitization to 8 allergens, and bronchial hyperresponsiveness to methacholine to assess cough and wheeze characteristics. Information was gathered on dampness, mold, ventilation, heating, housing quality, smoking, and environmental tobacco smoke exposure. Results. Most exposures were associated with cough alone or cough in combination with wheeze. Smoking, past smoking, and environmental tobacco smoke exposure were strongly associated with dry cough and wheeze. The use of coal for heating was associated with dry cough. Leaks, mold, and lack of kitchen ventilation were associated with cough and wheeze. Nocturnal cough and productive cough were associated with specific types of sensitization, but dry cough was not. Productive cough was associated with hyperresponsiveness to methacholine. Conclusions. Several different types of indoor exposures, including environmental tobacco smoke exposure, are important contributors to morbidity associated with cough and wheeze. A vigorous preventive strategy designed to lower exposures to indoor risk factors would lower rates of respiratory morbidity. PMID:17666696

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

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

    2012-01-01

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

  12. Diagnosis and Anti-Reflux Therapy for GERD with Respiratory Symptoms: A Study Using Multichannel Intraluminal Impedance-pH Monitoring

    Zhang, Chao; Wu, Jimin; Hu, Zhiwei; Yan, Chao; Gao, Xiang; Liang, Weitao; Liu, Diangang; Li, Fei; Wang, Zhonggao

    2016-01-01

    Background/Aims Respiratory symptoms are often associated with gastroesophageal reflux disease (GERD). Although the role of multichannel intraluminal impedance–pH (MII-pH) monitoring in GERD is clear, little is known regarding the characteristics of patients with respiratory symptoms based on MII-pH monitoring and anti-reflux therapy. We evaluated a cohort of GERD patients to identify the MII-pH parameters of GERD-related respiratory symptoms and to assess the anti-reflux therapy outcomes. Methods We undertook a prospective study of patients who were referred for GERD evaluation from January 2011 to January 2012. One hundred ninety-five patients underwent MII-pH monitoring and esophageal manometry, and one hundred sixty-five patients underwent invasive anti-reflux therapy that included laparoscopic Toupet fundoplication (LTF) and the Stretta procedure. The patient characteristics and MII-pH parameters were analyzed, and the symptom scores were assessed at baseline and at 1- and 3-year follow-up evaluations. Results Of the 195 patients, 96 (49.2%) exhibited respiratory symptoms and significantly more reflux episodes (70.7±29.3) than patients without respiratory symptoms (64.7±24.4, p = 0.044) based on the MII-pH monitoring results. Moreover, the group of patients with respiratory symptoms exhibited more proximal reflux episodes (35.2±21.3) than the non-respiratory symptomatic group (28.3±17.9, p = 0.013). One hundred twenty-five patients following the Stretta procedure (n = 60, 31 with respiratory symptoms) or LTF (n = 65, 35 with respiratory symptoms) completed the designated 3-year follow-up period and were included in the final analysis. The symptom scores after anti-reflux therapy all decreased relative to the corresponding baseline values (p0.05). However, LTF significantly reduced the recurrence (re-operation) rate compared with the Stretta procedure (0 vs. 19.4%, p = 0.006). Conclusions MII-pH monitoring effectively detected respiratory

  13. Diagnosis and Anti-Reflux Therapy for GERD with Respiratory Symptoms: A Study Using Multichannel Intraluminal Impedance-pH Monitoring.

    Chao Zhang

    Full Text Available Respiratory symptoms are often associated with gastroesophageal reflux disease (GERD. Although the role of multichannel intraluminal impedance-pH (MII-pH monitoring in GERD is clear, little is known regarding the characteristics of patients with respiratory symptoms based on MII-pH monitoring and anti-reflux therapy. We evaluated a cohort of GERD patients to identify the MII-pH parameters of GERD-related respiratory symptoms and to assess the anti-reflux therapy outcomes.We undertook a prospective study of patients who were referred for GERD evaluation from January 2011 to January 2012. One hundred ninety-five patients underwent MII-pH monitoring and esophageal manometry, and one hundred sixty-five patients underwent invasive anti-reflux therapy that included laparoscopic Toupet fundoplication (LTF and the Stretta procedure. The patient characteristics and MII-pH parameters were analyzed, and the symptom scores were assessed at baseline and at 1- and 3-year follow-up evaluations.Of the 195 patients, 96 (49.2% exhibited respiratory symptoms and significantly more reflux episodes (70.7±29.3 than patients without respiratory symptoms (64.7±24.4, p = 0.044 based on the MII-pH monitoring results. Moreover, the group of patients with respiratory symptoms exhibited more proximal reflux episodes (35.2±21.3 than the non-respiratory symptomatic group (28.3±17.9, p = 0.013. One hundred twenty-five patients following the Stretta procedure (n = 60, 31 with respiratory symptoms or LTF (n = 65, 35 with respiratory symptoms completed the designated 3-year follow-up period and were included in the final analysis. The symptom scores after anti-reflux therapy all decreased relative to the corresponding baseline values (p0.05. However, LTF significantly reduced the recurrence (re-operation rate compared with the Stretta procedure (0 vs. 19.4%, p = 0.006.MII-pH monitoring effectively detected respiratory-related predictive parameters, including total

  14. Effectiveness of assisted and unassisted cough capacity in amyotrophic lateral sclerosis patients.

    Sancho, Jesús; Servera, Emilio; Bañuls, Pilar; Marín, Julio

    2017-11-01

    Decreased cough capacity during a respiratory infection is one of the main causes of acute respiratory failure and hospitalisation in amyotrophic lateral sclerosis (ALS). To determine whether a respiratory measurement could identify the effectiveness of cough capacity in ALS during a respiratory infection. This was a prospective study of all ALS patients who were treated at a respiratory care unit due to a respiratory infection from 2012 to 2016. The effectiveness of unassisted and assisted coughing was evaluated and respiratory function tests were performed during the acute episode. Forty-eight ALS patients were enrolled, with only four having an effective unassisted cough. The variable which predicted unassisted cough effectiveness was peak cough flow (PCF) (OR 4499.27; 95%CI 3.60-3219086.19; p = 0.022) with a cut-off point of 2.77 L/s (166 L/min). For manually assisted coughing, the predictor of cough effectiveness was manually assisted PCF (cut-off point of 2.82-169 L/min) (OR 2198.602; 95% CI 3.750-1351691.42; p = 0.019). Mechanically assisted PCF (cut-off point of 2.95-177 L/min) was found to be the predictor of mechanically assisted coughing effectiveness (OR 23.40; 95% CI 2.11-258.96; p = 0.010). During a respiratory infection in ALS patients, the effectiveness of assisted and unassisted cough capacity depends on the PCF generated.

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

    Zeleke Zeyede K

    2011-11-01

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

  16. Questionnaire layout and wording influence prevalence and risk estimates of respiratory symptoms in a population cohort.

    Ekerljung, Linda; Rönmark, Eva; Lötvall, Jan; Wennergren, Göran; Torén, Kjell; Lundbäck, Bo

    2013-01-01

    Results of epidemiological studies are greatly influenced by the chosen methodology. The study aims to investigate how two frequently used questionnaires (Qs), with partly different layout, influence the prevalence of respiratory symptoms. A booklet containing two Qs, the Global Allergy and Asthma European Network Q and the Obstructive Lung Disease in Northern Sweden Q, was mailed to 30,000 subjects aged 16-75years in West Sweden; 62% responded. Sixteen questions were included in the analysis: seven identical between the Qs, four different in set-up and five with the same layout but different wording. Comparisons were made using differences in proportions, observed agreement and Kappa statistics.  Identical questions yielded similar prevalences with high observed agreement and kappa values. Questions with different set-up or differences in wording resulted in significantly different prevalences with lower observed agreement and kappa values. In general, the use of follow-up questions, excluding subjects answering no to the initial question, resulted in 2.9-6.7% units lower prevalence. The question set-up has great influences on epidemiological results, and specifically questions that are set up to be excluded based on a previous no answer leads to lower prevalence compared with detached questions. Therefore, Q layout and exact wording of questions has to be carefully considered when comparing studies. © 2012 Blackwell Publishing Ltd.

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

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

    2016-01-01

    Respiratory sinus arrhythmia (RSA) reactivity, an index of cardiac vagal tone, has been linked to self-regulation and the severity and course of depression (Rottenberg, 2007). Although initial data supports the proposition that RSA withdrawal during a sad film is a specific predictor of depression course (Fraguas, 2007; Rottenberg, 2005), the robustness and specificity of this finding are unclear. To provide a stronger test, RSA reactivity to three emotion films (happy, sad, fear) and to a more robust stressor, a speech task, were examined in currently depressed individuals (n=37), who were assessed for their degree of symptomatic improvement over 30weeks. Robust RSA reactivity to the sad film uniquely predicted overall symptom improvement over 30weeks. RSA reactivity to both sad and stressful stimuli predicted the speed and maintenance of symptomatic improvement. The current analyses provide the most robust support to date that RSA withdrawal to sad stimuli (but not stressful) has specificity in predicting the overall symptomatic improvement. In contrast, RSA reactivity to negative stimuli (both sad and stressful) predicted the trajectory of depression course. Patients' engagement with sad stimuli may be an important sign to attend to in therapeutic settings. Copyright © 2015 Elsevier B.V. All rights reserved.

  18. Sensitisation to common allergens and respiratory symptoms in endotoxin exposed workers: a pooled analysis.

    Basinas, Ioannis; Schlünssen, Vivi; Heederik, Dick; Sigsgaard, Torben; Smit, Lidwien A M; Samadi, Sadegh; Omland, Oyvind; Hjort, Charlotte; Madsen, Anne Mette; Skov, Simon; Wouters, Inge M

    2012-02-01

    To test the hypotheses that current endotoxin exposure is inversely associated with allergic sensitisation and positively associated with non-allergic respiratory diseases in four occupationally exposed populations using a standardised analytical approach. Data were pooled from four epidemiological studies including 3883 Dutch and Danish employees in veterinary medicine, agriculture and power plants using biofuel. Endotoxin exposure was estimated by quantitative job-exposure matrices specific for the study populations. Dose-response relationships between exposure, IgE-mediated sensitisation to common allergens and self-reported health symptoms were assessed using logistic regression and generalised additive modelling. Adjustments were made for study, age, sex, atopic predisposition, smoking habit and farm childhood. Heterogeneity was assessed by analysis stratified by study. Current endotoxin exposure was dose-dependently associated with a reduced prevalence of allergic sensitisation (ORs of 0.92, 0.81 and 0.66 for low mediate, high mediate and high exposure) and hay fever (ORs of 1.16, 0.81 and 0.58). Endotoxin exposure was a risk factor for organic dust toxic syndrome, and levels above 100 EU/m(3) significantly increased the risk of chronic bronchitis (pOccupational endotoxin exposure has a protective effect on allergic sensitisation and hay fever but increases the risk for organic dust toxic syndrome and chronic bronchitis. Endotoxin's protective effects are most clearly observed among agricultural workers.

  19. Attentional modulation of reflex cough.

    Janssens, Thomas; Silva, Mitchell; Davenport, Paul W; Van Diest, Ilse; Dupont, Lieven J; Van den Bergh, Omer

    2014-07-01

    Reflex cough is a defensive response generated in the brainstem in response to chemical and mechanical stimulation of the airways. However, converging evidence shows that reflex cough is also influenced by central neural control processes. In this study, we investigate whether reflex cough can be modulated by attentional focus on either external stimuli or internal cough-related stimuli. Healthy volunteers (N = 24; seven men; age range, 18-25 years) completed four blocks of citric acid-induced cough challenges while, simultaneously, auditory stimuli were presented. Within each block, four concentrations were administered (30, 100, 300 and 1,000 mM, randomized). During two subsequent blocks, participants focused their attention externally (counting tones). During the other two blocks, participants focused their attention internally (counting coughs). The order of attentional focus was counterbalanced across participants. Ratings of the urge to cough were collected after each challenge. Cough frequency was determined by audio recording. Cough frequency was higher when participants focused their attention internally vs externally (P Reflex cough can be modulated by attentional focus. Internally focused attention may be a mechanism involved in excessive (idiopathic) cough, while an external focus may be introduced as part of treatments targeting excessive cough.

  20. Validation of a short form Wisconsin Upper Respiratory Symptom Survey (WURSS-21

    Highstrom Alex D

    2009-08-01

    Full Text Available Abstract Background The Wisconsin Upper Respiratory Symptom Survey (WURSS is an illness-specific health-related quality-of-life questionnaire outcomes instrument. Objectives Research questions were: 1 How well does the WURSS-21 assess the symptoms and functional impairments associated with common cold? 2 How well can this instrument measure change over time (responsiveness? 3 What is the minimal important difference (MID that can be detected by the WURSS-21? 4 What are the descriptive statistics for area under the time severity curve (AUC? 5 What sample sizes would trials require to detect MID or AUC criteria? 6 What does factor analysis tell us about the underlying dimensional structure of the common cold? 7 How reliable are items, domains, and summary scores represented in WURSS? 8 For each of these considerations, how well does the WURSS-21 compare to the WURSS-44, Jackson, and SF-8? Study Design and Setting People with Jackson-defined colds were recruited from the community in and around Madison, Wisconsin. Participants were enrolled within 48 hours of first cold symptom and monitored for up to 14 days of illness. Half the sample filled out the WURSS-21 in the morning and the WURSS-44 in the evening, with the other half reversing the daily order. External comparators were the SF-8, a 24-hour recall general health measure yielding separate physical and mental health scores, and the eight-item Jackson cold index, which assesses symptoms, but not functional impairment or quality of life. Results In all, 230 participants were monitored for 2,457 person-days. Participants were aged 14 to 83 years (mean 34.1, SD 13.6, majority female (66.5%, mostly white (86.0%, and represented substantive education and income diversity. WURSS-21 items demonstrated similar performance when embedded within the WURSS-44 or in the stand-alone WURSS-21. Minimal important difference (MID and Guyatt's responsiveness index were 10.3, 0.71 for the WURSS-21 and 18.5, 0

  1. Lung function and prevalence of respiratory symptoms in Norwegian crab processing workers

    Thomassen, Marte Renate; Aasmoe, Lisbeth; Bang, Berit E.; Braaten, Tonje

    2017-01-01

    Source at http://dx.doi.org/10.1080/22423982.2017.1313513 Background: Seafood processing workers have an increased risk of developing occupational asthma. This has not been studied among Norwegian crab processing workers, nor has the respiratory health of exposed workers been compared to a control group. Objectives: Assessing the impact of working in the crab processing industry on workers ’ respiratory health. Design: A cross-sectional study of the respiratory health i...

  2. Effects of cooking fuel smoke on respiratory symptoms and lung function in semi-rural women in Cameroon.

    Mbatchou Ngahane, Bertrand Hugo; Afane Ze, Emmanuel; Chebu, Cyrille; Mapoure, Njankouo Yacouba; Temfack, Elvis; Nganda, Malea; Luma, Namme Henry

    2015-01-01

    Indoor air pollution is a major health problem in the developing world. In sub-Saharan Africa more than 90% of people rely on biomass to meet their domestic energy demands. Pollution from biomass fuel ranks 10th among preventable risk factors contributing to the global burden of diseases. The present study aimed to determine the prevalence of respiratory symptoms and the factors associated with reduced lung function in a population of women exposed to cooking fuel smoke. A cross-sectional study was conducted in a semi-rural area in Cameroon. We compared forced respiratory volume between women using wood (n = 145) and women using alternative sources of energy (n = 155) for cooking. Chronic bronchitis was found in 7·6% of the wood smoke group and 0·6% in the alternative fuels group. We observed two cases of airflow obstruction in the wood smoke group. Factors associated with lung function impairment were chronic bronchitis, use of wood as cooking fuel, age, and height. Respiratory symptoms and reduced lung function are more pronounced among women using wood as cooking fuel. Improved stoves technology should be developed to reduce the effects of wood smoke on respiratory health.

  3. Daytime napping and increased risk of incident respiratory diseases: symptom, marker, or risk factor?

    Leng, Yue; Wainwright, Nick W J; Cappuccio, Francesco P; Surtees, Paul G; Hayat, Shabina; Luben, Robert; Brayne, Carol; Khaw, Kay-Tee

    2016-07-01

    We have identified a strong association between daytime napping and increased mortality risk from respiratory diseases, but little is known about the relationship between daytime napping and respiratory morbidity. Data were drawn from the European Prospective Investigation into Cancer and Nutrition-Norfolk cohort. Participants reported napping habits during 1998-2000 and were followed up for respiratory disease hospital admissions until March 2009. Cox proportional hazards regression was used to examine the association between daytime napping and respiratory disease incidence risk. The study sample included 10,978 men and women with a mean age of 61.9 years, and a total of 946 incident respiratory disease cases were recorded. After adjustment for age, sex, social class, education, marital status, employment status, nightshift work, body mass index, physical activity, smoking, alcohol intake, self-reported general health, hypnotic drug use, habitual sleep duration, and preexisting health conditions, daytime napping was associated with an increase in the overall respiratory disease incidence risk (hazard ratio (HR) = 1.32, 95% confidence interval (CI) 1.15, 1.52 for napping respiratory diseases, especially for the risk of chronic lower respiratory diseases (HR = 1.52, 95% CI: 1.18, 1.96 for napping respiratory disease incidence risk. Further studies are required to confirm these findings and help understand potential mechanisms. Copyright © 2016 The Author(s). Published by Elsevier B.V. All rights reserved.

  4. Sex differences in cough reflex.

    Plevkova, J; Buday, T; Kavalcikova-Bogdanova, N; Ioan, I; Demoulin-Alexikova, S

    2017-11-01

    Majority of patients visiting cough clinics are postmenopausal women, who are affected by intractable cough for years. Why the cough reflex becomes exaggerated in women is not known. Basic research excludes females from the studies contributing to the sex bias which may be responsible for lack of understanding of "hypersensitive" cough in women. Biological and behavioural differences between women and men are the factors affecting cough physiology. Gender also shapes the patterns of behaviour and determines the character of environmental exposures which differs between sexes. The article offers an insight into the physiology of the cough, differences in the maturation of it and biological, social and behavioural factors contributing to the sex differences in cough. Copyright © 2016 Elsevier B.V. All rights reserved.

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

    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.

  6. Effects of a smoke-free law on hair nicotine and respiratory symptoms of restaurant and bar workers.

    Hahn, Ellen J; Rayens, Mary Kay; York, Nancy; Okoli, Chizimuzo T C; Zhang, Mei; Dignan, Mark; Al-Delaimy, Wael K

    2006-09-01

    Bar and restaurant workers' exposure to secondhand smoke (SHS) was compared before and 3 and 6 months after implementation of a smoke-free ordinance. Hair nicotine, self-reported exposure to SHS, and respiratory symptoms were assessed on 105 smoking and nonsmoking workers from randomly selected establishments in Lexington, Kentucky. Thirty-eight percent were current smokers with more than half smoking 10 or fewer cigarettes per day. Workers provided a hair sample at baseline and at the 3-month interview. There was a significant decline in hair nicotine 3 months postlaw when controlling for cigarettes smoked per day. Bar workers showed a significantly larger decline in hair nicotine compared with restaurant workers. The only significant decline in SHS exposure was in the workplace and other public places. Regardless of smoking status, respiratory symptoms declined significantly postlaw. Hospitality workers demonstrated significant declines in hair nicotine and respiratory symptoms after the law. Comprehensive smoke-free laws can provide the greatest protection to bar workers who are the most vulnerable to SHS exposure at work.

  7. Differentiation of Lung Cancer, Empyema, and Abscess Through the Investigation of a Dry Cough.

    Urso, Brittany; Michaels, Scott

    2016-11-24

    An acute dry cough results commonly from bronchitis or pneumonia. When a patient presents with signs of infection, respiratory crackles, and a positive chest radiograph, the diagnosis of pneumonia is more common. Antibiotic failure in a patient being treated for community-acquired pneumonia requires further investigation through chest computed tomography. If a lung mass is found on chest computed tomography, lung empyema, abscess, and cancer need to be included on the differential and managed aggressively. This report describes a 55-year-old Caucasian male, with a history of obesity, recovered alcoholism, hypercholesterolemia, and hypertension, presenting with an acute dry cough in the primary care setting. The patient developed signs of infection and was found to have a lung mass on chest computed tomography. Treatment with piperacillin-tazobactam and chest tube placement did not resolve the mass, so treatment with thoracotomy and lobectomy was required. It was determined through surgical investigation that the patient, despite having no risk factors, developed a lung abscess. Lung abscesses rarely form in healthy middle-aged individuals making it an unlikely cause of the patient's presenting symptom, dry cough. The patient cleared his infection with proper management and only suffered minor complications of mild pneumoperitoneum and pneumothorax during his hospitalization.

  8. A Clinical Trial of Kampo Formulae for the Treatment of Symptoms of Yusho, a Poisoning Caused by Dioxins and Related Organochlorine Compounds

    Uchi, Hiroshi; Tokunaga, Shoji; Mitoma, Chikage; Shibata, Satoko; Hamada, Naoki; Nakanishi, Yoichi; Kajiwara, Junboku; Yoshimura, Takesumi; Furue, Masutaka

    2011-01-01

    The objective of this study was to evaluate the effectiveness of traditional herbal medicines (Kampo) on the symptoms of Yusho. Yusho is a mass food poisoning that was caused by ingestion of rice oil contaminated with dioxins and related organochlorines in 1968. Patients with Yusho suffer from skin symptoms (acneform eruptions, liability to suppuration and pigmentation), respiratory symptoms (cough and expectoration of sputum), neurological symptoms (numbness and paresthesia of extremities), ...

  9. Importance of placebo effect in cough clinical trials.

    Eccles, Ron

    2010-01-01

    Cough is a unique symptom because, unlike sneeze and other symptoms, it can be under voluntary control and this complicates clinical trials on cough medicines. All over-the-counter cough medicines (OTC) are very effective treatments because of their placebo effect. The placebo effect is enhanced by expectancy related to advertising, brand, packaging, and formulation. This placebo effect creates a problem for the conduct of clinical trials on OTC cough medicines that attempt to demonstrate the efficacy of a pharmacological agent above that of any placebo effect. Up to 85% of the efficacy of some cough medicines can be attributed to a placebo effect. The placebo effect apparent in clinical trials consists of several components: natural recovery, regression of cough response toward mean, demulcent effect, effect of sweetness, voluntary control, and effects related to expectancy and meaning of the treatment. The placebo effect has been studied most in the pain model, and placebo analgesia is reported to depend on the activation of endogenous opioid systems in the brain; this model may be applicable to cough. A balanced placebo design may help to control for the placebo effect, but this trial design may not be acceptable due to deception of patients. The placebo effect in clinical trials may be controlled by use of a crossover design, where feasible, and the changes in the magnitude of the placebo effect in this study design are discussed.

  10. Pharmacology of Bradykinin-Evoked Coughing in Guinea Pigs.

    Hewitt, Matthew M; Adams, Gregory; Mazzone, Stuart B; Mori, Nanako; Yu, Li; Canning, Brendan J

    2016-06-01

    Bradykinin has been implicated as a mediator of the acute pathophysiological and inflammatory consequences of respiratory tract infections and in exacerbations of chronic diseases such as asthma. Bradykinin may also be a trigger for the coughing associated with these and other conditions. We have thus set out to evaluate the pharmacology of bradykinin-evoked coughing in guinea pigs. When inhaled, bradykinin induced paroxysmal coughing that was abolished by the bradykinin B2 receptor antagonist HOE 140. These cough responses rapidly desensitized, consistent with reports of B2 receptor desensitization. Bradykinin-evoked cough was potentiated by inhibition of both neutral endopeptidase and angiotensin-converting enzyme (with thiorphan and captopril, respectively), but was largely unaffected by muscarinic or thromboxane receptor blockade (atropine and ICI 192605), cyclooxygenase, or nitric oxide synthase inhibition (meclofenamic acid and N(G)-nitro-L-arginine). Calcium influx studies in bronchopulmonary vagal afferent neurons dissociated from vagal sensory ganglia indicated that the tachykinin-containing C-fibers arising from the jugular ganglia mediate bradykinin-evoked coughing. Also implicating the jugular C-fibers was the observation that simultaneous blockade of neurokinin2 (NK2; SR48968) and NK3 (SR142801 or SB223412) receptors nearly abolished the bradykinin-evoked cough responses. The data suggest that bradykinin induces coughing in guinea pigs by activating B2 receptors on bronchopulmonary C-fibers. We speculate that therapeutics targeting the actions of bradykinin may prove useful in the treatment of cough. Copyright © 2016 by The American Society for Pharmacology and Experimental Therapeutics.

  11. Impact of chronic cough on quality of life.

    French, C L; Irwin, R S; Curley, F J; Krikorian, C J

    Cough is the most common complaint for which adult patients seek medical care in the United States; however, the reason(s) for this is unknown. To determine whether chronic cough was associated with adverse psychosocial or physical effects on the quality of life and whether the elimination of chronic cough with specific therapy improved these adverse effects. The study design was a prospective before-and-after intervention trial with patients serving as their own controls. Study subjects were a convenience sample of 39 consecutive and unselected adult patients referred for evaluation and management of a chronic, persistently troublesome cough. Baseline data were available for 39 patients and follow-up for 28 patients (22 women and 6 men). At baseline, demographic, Adverse Cough Outcome Survey (ACOS), and Sickness Impact Profile (SIP) data were collected and patients were managed according to a validated, systematic protocol. Following specific therapy for cough, ACOS and SIP instruments were readministered. The ages, sex, duration, and spectra and frequencies of the causes of cough were similar to multiple other studies. At baseline, patients reported a mean +/- SD of 8.6 +/- 4.8 types of adverse occurrences related to cough. There were significant correlations between multiple ACOS items and total, physical, and psychosocial SIP scores. Psychosocial score correlated with total number of symptoms (PSIP scores. Multiple linear regression analysis showed that 54% of variability of the psychosocial SIP score was explained by 4 ACOS items while none of the physical score was explained. Chronic cough was associated with deterioration in patients' quality of life. The health-related dysfunction was most likely psychosocial. The ACOS and SIP appear to be valid tools in assessing the impact of chronic cough.

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

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

    2013-09-01

    Chronic obstructive pulmonary disease (COPD), once regarded as a disease of developed countries, is now recognised as a common disease in low- and middle-income countries. No studies have been performed to examine how the community in resource poor settings of a rural area in sub-Saharan Africa lives with chronic respiratory symptoms. To explore beliefs and attitudes concerning health (particularly respiratory illnesses), use of biomass fuels, tobacco smoking, and the use of health services. A qualitative study was undertaken in a rural area of Masindi district in Uganda, using focus group discussions with 10-15 members of the community in 10 randomly selected villages. Respiratory symptoms were common among men, women, and children. In several communities respiratory symptoms were stigmatised and often associated with tuberculosis. Almost all the households used firewood for cooking and the majority cooked indoors without any ventilation. The extent of exposure to tobacco and biomass fuel smoke was largely determined by their cultural tradition and gender, tribal origin and socioeconomic factors. Many people were unaware of the damage to respiratory health caused by these risk factors, notably the disproportionate effect of biomass smoke in women and children. The knowledge of chronic respiratory diseases, particularly COPD, is poor in the rural community in sub-Saharan Africa. The lack of knowledge has created different beliefs and attitudes concerning respiratory symptoms. Few people are aware of the relation between smoke and respiratory health, leading to extensive exposure to mostly biomass-related smoke.

  13. Born with Protection against Whooping Cough

    2015-01-22

    This podcast provides information about whooping cough, a disease that can be deadly for babies, and CDC’s recommendation that all women receive the Tdap vaccine during the third trimester of every pregnancy so their babies can be born with protection from this serious disease.  Created: 1/22/2015 by National Center for Immunization and Respiratory Diseases (NCIRD), Division of Bacterial Diseases (DBD), Meningitis and Vaccine Preventable Diseases Branch (MVPDB).   Date Released: 1/22/2015.

  14. Sensitisation to common allergens and respiratory symptoms in endotoxin exposed workers: a pooled analysis

    Basinas, I.|info:eu-repo/dai/nl/313908206; Schlünssen, V.; Heederik, D.|info:eu-repo/dai/nl/072910542; Sigsgaard, T.; Smit, L.A.|info:eu-repo/dai/nl/311470882; Samadi, S.|info:eu-repo/dai/nl/304838551; Omland, O.; Hjort, C.; Madsen, A.M.; Skov, S.; Wouters, I.M.|info:eu-repo/dai/nl/274156652

    2012-01-01

    OBJECTIVE: To test the hypotheses that current endotoxin exposure is inversely associated with allergic sensitisation and positively associated with non-allergic respiratory diseases in four occupationally exposed populations using a standardised analytical approach. METHODS: Data were pooled from

  15. Asthma, respiratory symptoms and lung function in children living near a petrochemical site.

    Rovira, E.; Cuadras, A.; Aguilar, X.; Esteban, L.; Borràs-Santos, A.; Zock, J.P.; Sunyer, J.

    2014-01-01

    Residential proximity to environmental hazards has been related to adverse health outcomes. Respiratory health and allergies in children living near petrochemical sites have not been extensively studied. We evaluated the association between residential proximity to the petrochemical site of

  16. Frequency of human bocavirus (HBoV) infection among children with febrile respiratory symptoms in Argentina, Nicaragua and Peru

    Salmón‐Mulanovich, Gabriela; Sovero, Merly; Laguna‐Torres, V. Alberto; Kochel, Tadeusz J.; Lescano, Andres G.; Chauca, Gloria; Sanchez, J. Felix; Rodriguez, Francisco; Parrales, Eduardo; Ocaña, Victor; Barrantes, Melvin; Blazes, David L.; Montgomery, Joel M.

    2010-01-01

    Please cite this paper as: Salmón‐Mulanovich et al. (2010) Frequency of human bocavirus (HBoV) infection among children with febrile respiratory symptoms in Argentina, Nicaragua and Peru. Influenza and Other Respiratory Viruses 5(1), 1–5. Background  Globally, respiratory infections are the primary cause of illness in developing countries, specifically among children; however, an etiological agent for many of these illnesses is rarely identified. Objectives  Our study aimed to estimate the frequency of human bocavirus (HBoV) infection among pediatric populations in Argentina, Nicaragua and Peru. Methods  We conducted a cross‐sectional study using stored samples of an influenza‐like illness surveillance program. Irrespective of previous diagnosis, nasopharyngeal or nasal swab specimens were randomly selected and tested using real‐time PCR from three sites during 2007 from patients younger than 6 years old. Results  A total of 568 specimens from Argentina (185), Nicaragua (192) and Peru (191) were tested. The prevalence of HBoV was 10·8% (95% CI: 6·3; 15·3) in Argentina, 33·3% in Nicaragua (95% CI: 26·6; 40·1) and 25·1% in Peru (95% CI: 18·9; 31·3). Conclusions  These findings demonstrate circulation of HBoV in Argentina, Nicaragua and Peru among children with influenza‐like symptoms enrolled in a sentinel surveillance program. PMID:21138534

  17. Description of nighttime cough epochs in patients with stable COPD GOLD II-IV.

    Fischer, Patrick; Gross, Volker; Kroenig, Johannes; Weissflog, Andreas; Hildebrandt, Olaf; Sohrabi, Keywan; Koehler, Ulrich

    Chronic cough is one of the main symptoms of COPD. Ambulatory objective monitoring provides novel insights into the determinants and characteristics of nighttime cough in COPD. Nighttime cough was monitored objectively by LEOSound lung sound monitor in patients with stable COPD II-IV. In 30 patients, with 10 patients in each stage group, nighttime cough was analyzed for epoch frequency, epoch severity (epoch length and coughs per epoch), and pattern (productive or nonproductive). Cough was found in all patients ranging from 1 to 294 events over the recording period. In 29 patients, cough epochs were monitored, ranging from 1 to 75 epochs. The highest amount of cough epochs was found in patients with COPD stage III. Active smokers had significantly more productive cough epochs (61%) than nonsmokers (24%). We found a high rate of nighttime cough epochs in patients with COPD, especially in those in stage III. Productive cough was predominantly found in patients with persistent smoking. LEOSound lung sound monitor offers a practical and valuable opportunity to evaluate cough objectively.

  18. Pilot study for home monitoring of cough capacity in amyotrophic lateral sclerosis: A case series.

    Paneroni, M; Trainini, D; Winck, J C; Vitacca, M

    2014-01-01

    Cough capacity derangement is associated with a high risk of pulmonary complications in amyotrophic lateral sclerosis patients when cough assistance is not routinely performed at home. The primary aim of this study was to evaluate the feasibility of a long-term home based daily self-monitoring cough capacity. Eighteen subjects were enrolled in a 9-month study at home. Changes in peak cough expiratory flow, oxygen saturation, respiratory discomfort and incidence of respiratory deterioration events were evaluated. In subjects presenting respiratory deterioration events, decline in the abovementioned respiratory variables was evaluated (#NCT00613899). During an average follow-up of 125±102 days, a total of 1175 measures were performed on 12 subjects. Mean compliance to proposed evaluations was 37±32% which worsened over time. Peak cough expiratory flow decreased by 15.08±32.43L/min monthly. Five subjects reported 6 episodes of respiratory deterioration events, after a mean period of 136±108 days. They had poor respiratory function and more years of disease. There was no difference in peak cough expiratory flow and its decline whether subjects presented respiratory deterioration events or not. In 4 subjects the respiratory discomfort score significantly worsened after respiratory deterioration events from 3.0±1.41 to 4.25±1.71. Daily self-monitoring of peak cough expiratory flow, oxygen saturation and respiratory discomfort seems difficult to obtain because of poor adherence to measures; this protocol does not seem to add anything to current practice of advising on clinical derangements. Confirmatory larger studies are necessary. Copyright © 2013 Sociedade Portuguesa de Pneumologia. Published by Elsevier España. All rights reserved.

  19. FEVER AS KEY SYMPTOM OF ACUTE RESPIRATORY INFECTIONS AND MODERN METHODS OF THERAPY FOR HIGH TEMPERATURE IN CHILDREN

    O.A. Solntseva

    2010-01-01

    Full Text Available Hyperthermia is the key symptom of acute respiratory infections (ARI. An increase in the body temperature is accompanied with phagocytosis activation, increased interferon synthesis, antibody genesis stimulation, lymphocytes activation and differentiation. Nevertheless, significant hyperthermia may result in my unfavourable consequences. It may particularly cause an exacerbation of chronic diseases. Modern therapy for hyperthermia is, therefore, an important aspect of treating children with ARI. The article outlines the modern approach to treating fever in children, identifies key criteria for selecting a medication. It also contains a case study of applying ibuprofen and data from various trials which verify the rationale for applying ibuprofen in children with hyperthermia that developed in conjunction with ARI.Key words: children, acute respiratory infections, hyperthermia, ibuprofen.(Voprosy sovremennoi pediatrii — Current Pediatrics. 2010;9(5:80-84

  20. Pesticides and respiratory symptoms among farmers Agrotóxicos e sintomas respiratórios entre agricultores

    Neice Müller Xavier Faria

    2005-12-01

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

  1. Respiratory Health Symptoms among Schoolchildren in Relation to Possible Food-Related Risk and Protective Factors.

    Wright, Caradee Y; Nkosi, Vusumuzi; Wichmann, Janine

    2018-03-13

    Respiratory health outcomes are among the top five causes of child morbidity and mortality around the world. We aimed to investigate possible food-related risk and protective factors for respiratory health outcomes in children. Structured questionnaires completed by primary caregivers of 10-year old children were used to collect information on demographics, socio-economic status, house characteristics and child respiratory health status. Upper (URIs) and Lower (LRIs) respiratory illnesses comprised hay fever, and wheezing, asthma and bronchitis, respectively. Eight hundred questionnaires were distributed, 648 retrieved and 420 completed in full (52.5% response rate). The hay fever 6-month prevalence was 22.4% and wheezing had the highest 6-month prevalence among the LRIs (13.8%). The majority of children ate vegetables (75.5%), fruit (69.3%) and chicken or fish (81.7%) regularly. Nearly half of the children (45.5%) regularly ate processed food. Eating processed food regularly was statistical significantly associated with wheeze (Adjusted Odds Ratio (OR) = 2.65; 95% CI: 1.38-5.08), hay fever (OR = 1.62; 95% CI: 1.09-2.64) and bronchitis (OR = 1.27; 95% CI: 1.06-2.56). The study found an association between regular consumption of processed foods and wheeze, hay fever and bronchitis among 10 year old children. The regular consumption of processed food plays a role in adverse respiratory health effects among children and healthy eating is emphasized.

  2. Managing patients with chronic cough: challenges and solutions

    Perotin JM

    2018-06-01

    Full Text Available Jeanne-Marie Perotin,1,2 Claire Launois,1 Maxime Dewolf,1 Antoine Dumazet,1 Sandra Dury,1 François Lebargy,1 Valérian Dormoy,2 Gaëtan Deslee1,2 1Department of Respiratory Diseases, University Hospital of Reims, Reims, France; 2INSERM UMRS 1250, University Hospital of Reims, Reims, France Abstract: Chronic cough is a common complaint and a frequent cause of medical consultation. Its management can be difficult. We present here an overview of the current guidelines for the management of chronic cough. Different steps are detailed, including the initial research of an obvious etiology and alert signs that should lead to further investigation of underlying condition. The diagnosis of the most frequent causes: asthma, non-asthmatic eosinophilic bronchitis, gastroesophageal reflux disease and upper airway cough syndrome should be considered, assessed and treated accordingly. Recent advances have been made in the comprehension of refractory chronic cough pathophysiology as well as its pharmacologic and non-pharmacologic treatment, especially speech pathology therapy. Keywords: asthma, gastroesophageal reflux, upper airway cough syndrome, chronic hypersensitivity syndrome, refractory chronic cough, speech pathology therapy

  3. Intraesophageal pressure recording improves the detection of cough during multichannel intraluminal impedance testing in children.

    Rosen, Rachel; Amirault, Janine; Giligan, Emily; Khatwa, Umakanth; Nurko, Samuel

    2014-01-01

    One of the primary reasons for referral for reflux testing is to correlate reflux events with symptoms such as cough. Adult studies have suggested that symptom recording is flawed and pediatricians feel this is an even more significant problem because there may be errors in both parental and patient reports. We hypothesize that intraesophageal pressure recording (IEPR) provides an objective method to identify coughs during reflux testing in children. We recruited 20 children undergoing multichannel intraluminal impedance with pH (pH-MII) testing for the evaluation of cough. We placed simultaneous intraesophageal pressure and pH-MII catheters. Tracings were blindly scored by 2 observers without knowledge of patient/parent symptom report. After the blinded scoring, patient/parent report of symptoms was recorded. Ninety-four percent of all coughs were detected by IEPR and only 48% of all coughs were reported by patients/parents. The mean time from the IEPR cough to the patient/parent cough was 11±16 seconds. Using IEPR as the criterion standard for the detection of cough, the sensitivity of patient report for the detection of cough is 46%. Using varying symptom windows because of the increased precision of IEPR, the number of patients with a positive symptom index could be reduced from 30% to 0%, preventing children from being falsely categorized as having reflux-related lung disease. Parental and patient symptom recording in children is inadequate for making the diagnosis of reflux-related lung disease. If patients undergo pH-MII testing for reflux-related cough, IEPR should become the new standard by which to correlate reflux with cough.

  4. The effect of exposure to biomass smoke on respiratory symptoms in adult rural and urban Nepalese populations

    Kurmi, Om P; Semple, Sean; Devereux, Graham S; Gaihre, Santosh; Lam, Kin Bong Hubert; Sadhra, Steven; Steiner, Markus FC; Simkhada, Padam; Smith, William CS; Ayres, Jon G

    2014-01-01

    Background Half of the world’s population is exposed to household air pollution from biomass burning. This study aimed to assess the relationship between respiratory symptoms and biomass smoke exposure in rural and urban Nepal. Methods A cross-sectional study of adults (16+ years) in a rural population (n = 846) exposed to biomass smoke and a non-exposed urban population (n = 802) in Nepal. A validated questionnaire was used along with measures of indoor air quality (PM2.5 and CO) and outdoor...

  5. Phenytoin-induced isolated chronic, nocturnal dry cough

    Fábio A. Nascimento

    2016-01-01

    Full Text Available We report a 72-year-old man with a four-year history of dyscognitive seizures (with occasional secondary generalization who developed isolated, nocturnal dry cough immediately after being started on PO phenytoin. The cough was not accompanied by any other symptom or sign as his physical exam was completely normal. Further investigation with chest CT and spirometry was unremarkable. This symptom persisted for six months and did not resolve until we weaned him off of phenytoin. According to the Naranjo Adverse Drug Reaction Probability Scale, his cough was classified as being probably (score +6 related to the use of this antiepileptic drug. To our knowledge, there has been only one study that reported phenytoin-triggered cough. It described a postoperative patient who developed cough and bronchospasm after receiving IV phenytoin. By reporting our case and discussing the literature on this specific topic, we have essentially two goals. First, we intend to remind clinicians that isolated persistent cough can be an adverse reaction to phenytoin. Second, we hope to encourage further studies that will be able to elucidate the association presented herein.

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

    Maciek Godycki-Cwirko

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

  7. Modified Valsalva test differentiates primary from secondary cough headache.

    Lane, Russell J M; Davies, Paul T G

    2013-03-28

    The current definition of cough headache includes provocation of the symptom by Valsalva manoeuvre, and it is generally believed that all cough headache results from a sudden increase in intracranial pressure. We sought to question that presumption and to determine whether the Valsalva test might distinguish primary from secondary cough headache. We examined 16 consecutive cough headache patients using a modified Valsalva test (exhalation into the connecting tube of a standard anaeroid sphygmomanometer to 60 mm Hg for 10 seconds). A positive response was recorded if the manoeuvre provoked headache. All patients subsequently underwent brain MRI. None of the patients had neurological signs. Eleven had positive modified Valsalva tests. Ten were found subsequently to have posterior fossa pathologies (secondary cough headache: 8 Chiari Type 1 malformations, 2 posterior fossa meningiomas). The cough headache was relieved following surgery in all cases. One patient with a positive Valsalva test had an apparently normal brain MRI but measurements of hindbrain and posterior fossa dimensions were consistent with 'posterior fossa crowdedness'. The remaining 5 patients had negative (4 patients) or equivocal (1 patient) Valsalva tests and normal MRI scans (primary cough headache). These findings suggest that secondary cough headache results from a transient increase in intracranial CSF pressure during exertion in the presence of obstruction to normal cerebrospinal fluid dynamics. The modified Valsalva test can also determine whether tonsillar herniation found on brain MRI is symptomatic. Primary cough headache appears to be caused by a different mechanism, possibly through congestion of the orbital venous plexus in the presence of jugular venous incompetence and a reduced threshold for trigeminal sensory activation.

  8. Does point-of-care ultrasonography cause discomfort in patients admitted with respiratory symptoms?

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

    2015-01-01

    of POCUS if they had to be examined for possible disease. METHODS: A questionnaire-based observational study was conducted in an ED. Inclusion criteria were one or more of the following: respiratory rate > 20/min, oxygen saturation chest pain. Patients...

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

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

    2014-01-01

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

  10. Occupational exposure to pesticides and respiratory health

    Ali Mamane

    2015-06-01

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

  11. An examination of the effects of mountaintop removal coal mining on respiratory symptoms and COPD using propensity scores.

    Hendryx, Michael; Luo, Juhua

    2015-01-01

    Previous research on public health consequences of mountaintop removal (MTR) coal mining has been limited by the observational nature of the data. The current study used propensity scores, a method designed to overcome this limitation, to draw more confident causal inferences about mining effects on respiratory health using non-experimental data. These data come from a health survey of 682 adults residing in two rural areas of Virginia, USA characterized by the presence or absence of MTR mining. Persons with a history of occupational exposure as coal miners were excluded. Nine covariates including age, sex, current and former smoking, overweight, obesity, high school education, college education, and exposure to coal as a home-heating source were selected to estimate propensity scores. Propensity scores were tested for balance and then used as weights to create quasi-experimental exposed and unexposed groups. Results indicated that persons in the mountaintop mining group had significantly (p < 0.0001) elevated prevalence of respiratory symptoms and chronic obstructive pulmonary disease. The results suggest that impaired respiratory health results from exposure to MTR environments and not from other risks.

  12. [Efficacy and tolerance of fenspiride in adult patients with acute respiratory tract infections].

    Płusa, T; Nawacka, D

    1998-12-01

    Fenspiride is an antiinflammatory drug targeted for the respiratory tract. In our study clinical efficacy and tolerance of drug were evaluated in 392 adult patients with acute respiratory tract infections. According to clinical criteria all observed symptoms were classified as mild, moderate and severe. The most of observed patients were included into moderate symptom score. Cough and nose obturation were dominant symptoms. All noticed changes in the upper respiratory tract were decreased after fenspiride therapy in 7 days trial. In 168 observed patients systemic and in 60 local acting antibiotics were successfully applied. Excellent tolerance of fenspiride was documented in 59% and good tolerance --in 34% of patients. Observed adverse reactions were classified as mild and in 20 patients fenspiride was rejected. Authors suggest that fenspiride therapy is save and successful in patient with acute respiratory tract infection. Good results in patients with bronchitis in decreasing of bronchospasm indicate fenspiride as a good tool in bronchial infection.

  13. Cough Variant Asthma in Medical Outpatient Department of a Tertiary Care Hospital in Bangladesh

    Rukhsana Parvin; Shekhar Bhattacharjee; Swapna Bhattacharjee

    2013-01-01

    Background: Cough variant asthma (CVA) is a subset of asthma where the only symptom is chronic persistent cough. Many cases go unrecognized due to lack of proper evaluation. Response to asthma medication with features supportive of airway hypersensitivity helps in management of this disease. Objective: To find out the proportion of cough variant asthma among the patients attending medicine outpatient department of Enam Medical College, Savar, Dhaka. Materials and Methods: This cross sectional...

  14. Pla a 2 and Pla a 3 reactivities identify plane tree-allergic patients with respiratory symptoms or food allergy.

    Scala, E; Cecchi, L; Abeni, D; Guerra, E C; Pirrotta, L; Locanto, M; Giani, M; Asero, R

    2017-04-01

    Nine hundred and thirty-nine rPla a 1, nPla a 2, and rPla a 3 ImmunoCAP ISAC reactors were studied. nPla a 2 pos MUXF3 pos but Pla a 1/2 neg subjects were excluded from the study because they were cross-reactive carbohydrate determinant reactors. Among the 764 remaining participants, 71.9% were Pla a 3 pos , 54.1% Pla a 2 pos , and 10.9% Pla a 1 pos . Among Pla a 3 reactors, 89.6% were Pru p 3 pos and 86.8% Jug 3 pos , but the strongest IgE recognition relationship was observed between Pla a 3 and Jug r 3. Distinctive clinical subsets could be documented among plane tree-allergic patients. Pla a 3 reactors had both local and systemic food-induced reactions, but lower past respiratory symptoms occurrence. Pla a 2 reactivity was associated with respiratory symptoms but inversely related to systemic reactions to food. Cosensitization to Pla a 2 and Pla a 3 was associated with a lower past incidence of severe food-induced reactions. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  15. PIDOTIMOD IN TREATMENT OF ACUTE RESPIRATORY INFECTION IN FREQUENTLY AILING CHILDREN

    F.S. Kharlamova

    2009-01-01

    Full Text Available This trial studied effectiveness and safety of pidotimoid (Imunorix in complex treatment of children with acute respiratory infection (ARI. Treatment with pidotimoid during 2 weeks (n = 30 resulted in lesser duration of fever and intoxication symptoms, and symptoms of laryngo-tracheitis, compared to control group (n = 30. Besides, children from pidotimoid group showed more rapid transformation of dry cough to hydrated cough, and decrease of its intensity. This beneficial change was accompanied by improvement of microbiocenosis. Effectiveness of pidotimoid was estimated by 73% of doctors as «good» (67% in control group. There was no any complication, related to treatment with this medication. The rate of repeated cases of ARI was three times lower then in control group in 6 months. All patients with ARI had no recurrent laryngeal stenosis.Key words: frequently ailing children, acute respiratory infection, treatment, prophylaxis, pidotimoid.(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(2:27-33

  16. Effect of a smoking ban on respiratory health in nonsmoking hospitality workers: a prospective cohort study.

    Rajkumar, Sarah; Stolz, Daiana; Hammer, Jürg; Moeller, Alexander; Bauer, Georg F; Huynh, Cong Khanh; Röösli, Martin

    2014-10-01

    The aim of this study was to examine the effect of a smoking ban on lung function, fractional exhaled nitric oxide, and respiratory symptoms in nonsmoking hospitality workers. Secondhand smoke exposure at the workplace, spirometry, and fractional exhaled nitric oxide were measured in 92 nonsmoking hospitality workers before as well as twice after a smoking ban. At baseline, secondhand smoke-exposed hospitality workers had lung function values significantly below the population average. After the smoking ban, the covariate-adjusted odds ratio for cough was 0.59 (95% confidence interval, 0.36 to 0.93) and for chronic bronchitis 0.75 (95% confidence interval, 0.55 to 1.02) compared with the preban period. The below-average lung function before the smoking ban indicates chronic damages from long-term exposure. Respiratory symptoms such as cough decreased within 12 months after the ban.

  17. Burden of Respiratory Disease in Korea: An Observational Study on Allergic Rhinitis, Asthma, COPD, and Rhinosinusitis.

    Yoo, Kwang Ha; Ahn, Hae Ryun; Park, Jae Kyoung; Kim, Jong Woong; Nam, Gui Hyun; Hong, Soon Kwan; Kim, Mee Ja; Ghoshal, Aloke Gopal; Muttalif, Abdul Razak Bin Abdul; Lin, Horng Chyuan; Thanaviratananich, Sanguansak; Bagga, Shalini; Faruqi, Rab; Sajjan, Shiva; Baidya, Santwona; Wang, De Yun; Cho, Sang Heon

    2016-11-01

    The Asia-Pacific Burden of Respiratory Diseases (APBORD) study is a cross-sectional, observational one which has used a standard protocol to examine the disease and economic burden of allergic rhinitis (AR), asthma, chronic obstructive pulmonary disorder (COPD), and rhinosinusitis across the Asia-Pacific region. Here, we report on symptoms, healthcare resource use, work impairment, and associated costs in Korea. Consecutive participants aged ≥18 years with a primary diagnosis of asthma, AR, COPD, or rhinosinusitis were enrolled. Participants and their treating physician completed a survey detailing respiratory symptoms, healthcare resource use, and work productivity and activity impairment. Costs included direct medical cost and indirect cost associated with lost work productivity. The study enrolled 999 patients. Patients were often diagnosed with multiple respiratory disorders (42.8%), with asthma/AR and AR/rhinosinusitis the most frequently diagnosed combinations. Cough or coughing up phlegm was the primary reason for the medical visit in patients with a primary diagnosis of asthma and COPD, whereas nasal symptoms (watery runny nose, blocked nose, and congestion) were the main reasons in those with AR and rhinosinusitis. The mean annual cost for patients with a respiratory disease was US$8,853 (SD 11,245) per patient. Lost productivity due to presenteeism was the biggest contributor to costs. Respiratory disease has a significant impact on disease burden in Korea. Treatment strategies for preventing lost work productivity could greatly reduce the economic burden of respiratory disease.

  18. Respiratory and skin health among glass microfiber production workers: a cross-sectional study

    Jaakkola Maritta S

    2009-08-01

    Full Text Available Abstract Background Only a few studies have investigated non-malignant respiratory effects of glass microfibers and these have provided inconsistent results. Our objective was to assess the effects of exposure to glass microfibers on respiratory and skin symptoms, asthma and lung function. Methods A cross-sectional study of 102 workers from a microfiber factory (response rate 100% and 76 office workers (73% from four factories in Thailand was conducted. They answered a questionnaire on respiratory health, occupational exposures, and lifestyle factors, and performed spirometry. Measurements of respirable dust were available from 2004 and 2005. Results Workers exposed to glass microfibers experienced increased risk of cough (adjusted OR 2.04, wheezing (adjOR 2.20, breathlessness (adjOR 4.46, nasal (adjOR 2.13 and skin symptoms (adjOR 3.89 and ever asthma (adjOR 3.51, the risks of breathlessness (95%CI 1.68–11.86 and skin symptoms (1.70–8.90 remaining statistically significant after adjustment for confounders. There was an exposure-response relation between the risk of breathlessness and skin symptoms and increasing level of microfiber exposure. Workers exposed to sensitizing chemicals, including phenol-formaldehyde resin, experienced increased risk of cough (3.43, 1.20–9.87 and nasal symptoms (3.07, 1.05–9.00. Conclusion This study provides evidence that exposure to glass microfibers increases the risk of respiratory and skin symptoms, and has an exposure-response relation with breathlessness and skin symptoms. Exposure to sensitizing chemicals increased the risk of cough and nasal symptoms. The results suggest that occupational exposure to glass microfibers is related to non-malignant adverse health effects, and that implementing exposure control measures in these industries could protect the health of employees.

  19. Recovery from Dysphagia Symptoms after Oral Endotracheal Intubation in Acute Respiratory Distress Syndrome Survivors. A 5-Year Longitudinal Study.

    Brodsky, Martin B; Huang, Minxuan; Shanholtz, Carl; Mendez-Tellez, Pedro A; Palmer, Jeffrey B; Colantuoni, Elizabeth; Needham, Dale M

    2017-03-01

    Nearly 60% of patients who are intubated in intensive care units (ICUs) experience dysphagia after extubation, and approximately 50% of them aspirate. Little is known about dysphagia recovery time after patients are discharged from the hospital. To determine factors associated with recovery from dysphagia symptoms after hospital discharge for acute respiratory distress syndrome (ARDS) survivors who received oral intubation with mechanical ventilation. This is a prospective, 5-year longitudinal cohort study involving 13 ICUs at four teaching hospitals in Baltimore, Maryland. The Sydney Swallowing Questionnaire (SSQ), a 17-item visual analog scale (range, 0-1,700), was used to quantify patient-perceived dysphagia symptoms at hospital discharge, and at 3, 6, 12, 24, 36, 48, and 60 months after ARDS. An SSQ score greater than or equal to 200 was used to indicate clinically important dysphagia symptoms at the time of hospital discharge. Recovery was defined as an SSQ score less than 200, with a decrease from hospital discharge greater than or equal to 119, the reliable change index for SSQ score. Fine and Gray proportional subdistribution hazards regression analysis was used to evaluate patient and ICU variables associated with time to recovery accounting for the competing risk of death. Thirty-seven (32%) of 115 patients had an SSQ score greater than or equal to 200 at hospital discharge; 3 died before recovery. All 34 remaining survivors recovered from dysphagia symptoms by 5-year follow-up, 7 (23%) after 6 months. ICU length of stay was independently associated with time to recovery, with a hazard ratio (95% confidence interval) of 0.96 (0.93-1.00) per day. One-third of orally intubated ARDS survivors have dysphagia symptoms that persist beyond hospital discharge. Patients with a longer ICU length of stay have slower recovery from dysphagia symptoms and should be carefully considered for swallowing assessment to help prevent complications related to dysphagia.

  20. Pulmonary function, respiratory symptoms, and dust exposures among workers engaged in early manufacturing processes of tea: a cohort study.

    Shieh, Tzong-Shiun; Chung, Jui-Jung; Wang, Chung-Jing; Tsai, Perng-Jy; Kuo, Yau-Chang; Guo, How-Ran

    2012-02-13

    To evaluate pulmonary function and respiratory symptoms in workers engaged in the early manufacturing processes of tea and to identify the associated factors, we conducted a study in a tea production area in Taiwan. We recruited tea workers who engaged in the early manufacturing process in the Mountain Ali area in Taiwan and a comparison group of local office workers who were matched for age, gender, and smoking habits. We performed questionnaire interviews, pulmonary function tests, skin prick tests, and measurement of specific IgE for tea on the participants and assessed tea dust exposures in the tea factories. The 91 participating tea workers had higher prevalence of respiratory symptoms than the comparison group (32 participants). Among tea workers, ball-rolling workers had the highest prevalence of symptoms and the highest exposures of inhalable dusts. At baseline, tea workers had similar pulmonary functions as the comparison group, but compared to the other tea workers ball-rolling workers had a lower ratio of the 1-second forced expiratory volume to forced vital capacity (FEV1/FVC) and a lower maximal mid-expiratory flow rate expressed as% of the predicted value--MMF (%pred). A total of 58 tea workers participated in the on-site investigation and the cross-shift lung function measurements. We found ball-rolling yielded the highest inhalable dust level, panning yielded the highest respirable dust level, and withering yielded the lowest levels of both dusts. Ball-rolling also yielded the highest coarse fraction (defined as inhalable dusts minus respirable dusts), which represented exposures from nose to tracheobronchial tract. During the shift, we observed significant declines in pulmonary function, especially in ball-rolling workers. Multiple regressions showed that age, height, work tasks, coarse fraction, and number of months working in tea manufacturing each year were independent predictors of certain pulmonary function parameters in tea workers. Tea

  1. Gastroesophageal reflux and upper gastrointestinal tract disorders in children with persistent or recurrent respiratory symptoms

    Urioste, A.; Orellana, P.; Harris, P.; Sanchez, I.; Holgren, N.

    2002-01-01

    Gastroesophageal Reflux (GER) and gastrointestinal (GI) dismotility disorders, can coexist in children with persistent and/or recurrent bronchopulmonary symptoms(RBPS) condition that eventually improve or disappear after the treatment of these GI disorders The goal of this study was to evaluated the presence of GER, abnormal esophageal transit, swallowing disorders and lung aspiration in children with RBPS. We performed standard scintigraphic gastrointestinal procedures in 67 children.; 36 boys, with a mean age of 1.75 yrs. (10 days-15 yrs),all of them presented with RBPS, 21 of them associated with GI symptoms and 20 with neurological symptoms. Thirty four out of 67 children (50.74%) had an abnormal scintigraphic finding; single or combined. Swallowing abnormalities was observed in 11 (16.4%), esophageal transit abnormalities was observed in 16 (23.9%), GER in 9 (13.4%) and lung aspiration in 6 (8.95%). 10 children had more than one abnormalities (14.9%). Among the 20 children with neurological symptoms, 75% had an abnormal scintigraphic study versus the 40.4% of children without neurological symptoms. In children with RBPS, abnormalities of gastrointestinal tract is not uncommon; 50.74% in our group, specially in children with neurological symptoms (75%). Scintigraphic procedure is a safe, sensible and non invasive technique that allows the simultaneous evaluation of different parameters of the gastrointestinal motility, in order to detect abnormalities that could explain the clinical features in children with RBPS

  2. PHYTOTHERAPY OF COUGH IN CHILDREN

    O.A. Danilyuk

    2008-01-01

    Full Text Available Characteristics of treatment of cough in children with herbal medications are presented in this article. Poly therapeutic effect of medicinal plants, its high biological activity, relatively low toxicity and wide therapeutic index explain a need of phyto therapy use in treatment of cough. Advantages of phyto therapy are described, children's doses, ways of application of herbal extracts are given. The use of plants depending on the stage of disease and principles of combination of herbal medications during treatment are described.Key words: phyto therapy, cough, medicinal plants.

  3. Respiratory syncytial virus (RSV bronchiolitis: comparative study of RSV groups A and B infected children

    Selir M. Straliotto

    1994-03-01

    Full Text Available The grouping characteristics of 29 respiratory syncitial virus (RSV present in nasopharyngeal cells collectedfrom hospitalized children with bronchiolitis during the 1990RSVseason in Porto Alegre, RS, were analysed. Twenty-two were grouped as belonging to group A and 7 to group B. Cyanosis, oxigen therapy, cough, lenght of hospitalization and atelectasis were observed to be more frequently found within group B infected children. Other clinical signs and symptoms were similarly found in both groups.

  4. A multilevel analysis of lifestyle variations in symptoms of acute respiratory infection among young children under five in Nigeria

    Oluwafunmilade A. Adesanya

    2016-08-01

    Full Text Available Abstract Background Nigeria has the second highest estimated number of deaths due to acute respiratory infection (ARI among children under five in the world. A common hypothesis is that the inequitable distribution of socioeconomic resources shapes individual lifestyles and health behaviors, which leads to poorer health, including symptoms of ARI. This study examined whether lifestyle factors are associated with ARI risk among Nigerian children aged less than 5 years, taking individual-level and contextual-level risk factors into consideration. Methods Data were obtained from the nationally representative 2013 Nigeria Demographic and Health Survey. A total of 28,596 surviving children aged 5 years or younger living in 896 communities were analyzed. We employed two-level multilevel logistic regressions to model the relationship between lifestyle factors and ARI symptoms. Results The multivariate results from multilevel regressions indicated that the odds of having ARI symptoms were increased by a number of lifestyle factors such as in-house biomass cooking (OR = 2.30; p < 0.01 and no hand-washing (OR = 1.66; p < 0.001. An increased risk of ARI symptoms was also significantly associated with living in the North West region and the community with a high proportion of orphaned/vulnerable children (OR = 1.74; p < 0.001. Conclusions Our findings underscore the importance of Nigerian children’s lifestyle within the neighborhoods where they reside above their individual characteristics. Program-based strategies that are aimed at reducing ARI symptoms should consider policies that embrace making available basic housing standards, providing improved cooking stoves and enhancing healthy behaviors.

  5. CHRONIC COUGH AND DENTAL EROSIONS IN A CHILD WITH GASTROESOPHAGEAL REFLUX EVALUATED BY PH-METRY ASSOCIATED WITH MULTICHANNEL INTRALUMINAL IMPEDANCE

    Felicia GALOŞ

    2013-12-01

    Full Text Available The clinical manifestations of the gastroesophageal reflux disease (GERD are multiple and heterogeneous, differing according to age and individual susceptibility. The relationship between respiratory manifestations and the gastroesophageal reflux (GER in children is a contro‑ versial topic on: proving or refuting either cause or effect, with special stress on the most important symptomcough. Dental erosions can be GERD-related, especially in the case of infants or of neurologically-impaired children. The case of a 4 year and 8 month-old child with gastroeso‑ phageal reflux, with typical (chronic vomiting and atypi‑ cal (chronic cough, dental erosions digestive manifestations, a diagnosis established by pH-metry asso‑ ciated with multichannel intraluminal impedance, will be discussed in the study.

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

    Guglielmina Fantuzzi

    2010-03-01

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

  7. Habit-tic cough: Presentation and outcome with simple reassurance.

    Wright, Marie F A; Balfour-Lynn, Ian M

    2018-04-01

    Our therapeutic approach to a habit/tic cough is simple reassurance in a single consultation. To quality assure our practice, we followed up children to determine outcomes at least 3 months after diagnosis. Consecutive children diagnosed over 6 years were studied. Medical records were analyzed retrospectively and parents answered a scripted verbal survey. Fifty-five patients were diagnosed (median age 9.9 years), with a median cough duration of 3 months (IQR 2-7.5 months, range up to 3 years). In 51/55 (93%) cases, cough was absent during sleep. 51/55 (93%) received prior medications with median 3 therapeutic trials, none of which resolved the cough. Follow-up was possible in 39/55 (71%) children after a median duration of 1.9 years. In 32/39 (82%), the cough had resolved completely (59% within 4 weeks, including 12% on the day), and it improved in 6/39 (15%). In the 26/39 (67%) parents who said they believed the diagnosis, there was 96% resolution of the cough, versus the 13/39 (33%) who were sceptical or disbelieving, when there was only 54% resolution. 7/39 (18%) children were later diagnosed with a tic disorder, functional symptoms, or a behavioural/psychiatric disorder. Habit cough can be diagnosed from the characteristic history; the crucial question is whether the cough disappears during sleep. We have shown successful long term outcomes following a single consultation with simple reassurance, but it is important that the child and parents believe the explanation. It is not uncommon for subsequent tic disorders or behavioral issues to emerge. © 2018 Wiley Periodicals, Inc.

  8. Sugar cane burning pollution and respiratory symptoms in schoolchildren in Monte Aprazível, Southeastern Brazil.

    Riguera, Denise; André, Paulo Afonso; Zanetta, Dirce Maria Trevisan

    2011-10-01

    To estimate the prevalence of respiratory symptoms and to analyze associated factors as well as peak expiratory flow measurements in schoolchildren. This is a descriptive cross-sectional study with schoolchildren aged 10-14 from the city of Monte Aprazível (Southeastern Brazil). Questionnaires containing the asthma and rhinitis components of the International Study of Asthma and Allergies in Childhood were administered. The questionnaires also approached sociodemographic characteristics, predisposing factors, and family and personal medical history. Repeated measures of peak expiratory flow in the children, and of black carbon and particulate matter (PM2,5) concentration levels were carried out. The prevalence of asthma and rhinitis symptoms was 11% and 33.2%, respectively. Among asthmatic children, 10.6% presented four or more wheezing attacks in the past 12 months. Past family history of bronchitis and rhinitis was associated with presence of asthma (p=0.002 and p PM2,5 concentration. The prevalence of asthma symptoms is below and that of rhinitis is above the national average. Although within acceptable levels, pollution in the cane trash burn season may contribute to the exacerbation of asthma and rhinitis episodes.

  9. Change in Psychological, Physiological, and Situational Factors in Adults After Treatment of Chronic Cough.

    French, Cynthia L; Crawford, Sybil L; Bova, Carol; Irwin, Richard S

    2017-09-01

    We hypothesized that addressing anxiety and depressive mood disorders will improve chronic cough severity and cough quality of life (CQOL). Major tenets of the theory of unpleasant symptoms were examined in a longitudinal observational study of consecutive adults with cough of > 8 weeks' duration treated in our cough clinic. At baseline and 3 and 6 months, subjects completed 3 Punum Ladders rating cough severity, the CQOL Questionnaire, the Depression, Anxiety, and Stress Scales-21, and the Duke Functional Social Support Questionnaire. Cross-sectional baseline and longitudinal regression analyses were conducted. Eighty subjects (55 women) with a mean age of 58.5 ± 11.1 years and a cough duration of 86.0 ± 123.7 months were enrolled. At baseline, worse cough severity was significantly associated with less education and worse ability to speak bothered by cough and the urge to cough. Worse CQOL was significantly associated with worse depression symptoms, urinary incontinence, and ability to speak; use of self-prescribed remedies; and younger age. Significant improvements in depression and stress symptoms occurred at 3 and 6 months. Anxiety symptoms improved, particularly in the first 3 months. Improvement in cough severity was significantly associated with less education, male sex, and improvement in ability to speak and urge to cough. Improvement in CQOL was significantly associated with improvement in urinary incontinence, urge to cough, anxiety symptoms, and use of self-prescribed remedies. Using the theory of unpleasant symptoms, we have come to appreciate that managing psychological, physiological, and situational factors in addition to focusing on identifying the cause of cough is important to maximize improvement in CQOL. Copyright © 2017 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

  10. Tobacco use among designated air pollution victims and its association with lung function and respiratory symptoms: a retrospective cross-sectional study.

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

    2014-07-31

    We sought to elucidate the long-term association of tobacco use and respiratory health in designated pollution victims with and without obstructive pulmonary defects. A retrospective cross-sectional study. The register of pollution victims in Kurashiki, Japan. 730 individuals over 65 years of age previously diagnosed with pollution-related respiratory disease. Patients were classified into four groups according to their smoking status and whether they had obstructive pulmonary disease. We then compared the prevalence of respiratory symptoms and lung function over time between groups. Spirometry was performed and a respiratory health questionnaire completed in the same season each year for up to 30 years. Rates of smoking and respiratory disease were high in our sample. Although respiratory function in non-smoking patients did not completely recover, the annual rate of change in lung function was within the normal range (prespiratory function did not fully recover despite improved air quality. Our results suggest that, in the context of exposure to air pollution, tobacco use causes additional loss of lung function and exacerbates respiratory symptoms. 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.

  11. High frequency of pertussis in older children and adolescents with prolonged cough in Turkey.

    Aslan, Aslı; Kurugöl, Zafer; Aydemir, Şöhret; Gürsel, Derya; Koturoğlu, Güldane

    2016-01-01

    This study aimed to determine the frequency of B. pertussis infection among Turkish children with prolonged cough. Nasopharyngeal specimens were collected from 7-18 year old children, presenting with prolonged cough of two to four weeks' duration. Specimens were examined for B. pertussis by PCR. Of 101 children with prolonged cough, 20 (19.8%) had a positive PCR testing for B. pertussis. Children who were vaccinated ≥5 years previously had a 6.13-fold higher risk of PCR-confirmed pertussis than those who were vaccinated pertussis (paroxysmal cough, whooping and post-tussive vomiting) were seen in 30%, 15% and 25% of the patients with positive PCR, respectively; 55% of them had only a prolonged cough without any classic symptoms. Pertussis is common among Turkish children with prolonged cough, even after implementation of a fifth dose of pertussis vaccination and despite high vaccination coverage.

  12. Evaluation of Chlamydia pneumoniae and Mycoplasma pneumoniae as etiologic agents of persistent cough in adolescents and adults.

    Wadowsky, Robert M; Castilla, Elias A; Laus, Stella; Kozy, Anita; Atchison, Robert W; Kingsley, Lawrence A; Ward, Joel I; Greenberg, David P

    2002-02-01

    Chlamydia pneumoniae and Mycoplasma pneumoniae were evaluated as agents of persistent cough in adolescents and adults (n = 491). Tests of 473 respiratory specimens by culture or PCR or both identified four episodes (0.8%) of M. pneumoniae-associated illness and no episodes of C. pneumoniae illness, suggesting that these bacteria do not frequently cause persistent cough.

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

    Ventura, Cesar E; Ramirez, Gloria; Vera, Victor

    2012-01-01

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

  14. Sensitisation to common allergens and respiratory symptoms in endotoxin exposed workers

    Basinas, Ioannis; Schlünssen, Vivi; Heederik, Dick

    2012-01-01

    Objective To test the hypotheses that current endotoxin exposure is inversely associated with allergic sensitisation and positively associated with non-allergic respiratory diseases in four occupationally exposed populations using a standardised analytical approach. Methods Data were pooled from...... four epidemiological studies including 3883 Dutch and Danish employees in veterinary medicine, agriculture and power plants using biofuel. Endotoxin exposure was estimated by quantitative job-exposure matrices specific for the study populations. Dose–response relationships between exposure, Ig...... Current endotoxin exposure was dose-dependently associated with a reduced prevalence of allergic sensitisation (ORs of 0.92, 0.81 and 0.66 for low mediate, high mediate and high exposure) and hay fever (ORs of 1.16, 0.81 and 0.58). Endotoxin exposure was a risk factor for organic dust toxic syndrome...

  15. Clinical and virological factors associated with gastrointestinal symptoms in patients with acute respiratory infection: a two-year prospective study in general practice medicine.

    Minodier, Laetitia; Masse, Shirley; Capai, Lisandru; Blanchon, Thierry; Ceccaldi, Pierre-Emmanuel; van der Werf, Sylvie; Hanslik, Thomas; Charrel, Remi; Falchi, Alessandra

    2017-11-22

    Gastrointestinal (GI) symptoms, such as diarrhea, vomiting, abdominal pain and nausea are not an uncommon manifestation of an acute respiratory infection (ARI). We therefore evaluated clinical and microbiological factors associated with the presence of GI symptoms in patients consulting a general practitioner (GP) for ARI. Nasopharyngeal swabs, stool specimens and clinical data from patients presenting to GPs with an ARI were prospectively collected during two winter seasons (2014-2016). Samples were tested by quantitative real-time PCR for 12 respiratory pathogen groups and for 12 enteric pathogens. Two hundred and four of 331 included patients (61.6%) were positive for at least one respiratory pathogen. Sixty-nine stools (20.8%) were positive for at least one pathogen (respiratory and/or enteric). GI symptoms were more likely declared in case of laboratory confirmed-enteric infection (adjusted odds ratio (aOR) = 3.2; 95% confidence interval [CI] [1.2-9.9]; p = 0.02) or human coronavirus (HCoV) infection (aOR = 2.7; [1.2-6.8]; p = 0.02). Consumption of antipyretic medication before the consultation seemed to reduce the risk of developing GI symptoms for patients with laboratory-confirmed influenza (aOR = 0.3; [0.1-0.6]; p = 0.002). The presence of GI symptoms in ARI patients could not be explained by the detection of respiratory pathogens in stools. However, the detection of enteric pathogens in stool samples could explained by the presence of GI symptoms in some of ARI cases. The biological mechanisms explaining the association between the presence of HCoVs in nasopharynx and GI symptoms need to be explored.

  16. Caring for cough : guiding diagnosis in primary care

    van Vugt, S.F.

    2013-01-01

    Proper diagnosis in the very common presented acute cough or other LRTI-like symptoms allows GPs to adequately treat and inform their patients about the expected course of their disease. Management depends on the assumed cause of the LRTI, which includes potentially life threatening pneumonia, as

  17. Test-retest repeatability of child's respiratory symptoms and perceived indoor air quality - comparing self- and parent-administered questionnaires.

    Lampi, Jussi; Ung-Lanki, Sari; Santalahti, Päivi; Pekkanen, Juha

    2018-02-09

    Questionnaires can be used to assess perceived indoor air quality and symptoms in schools. Questionnaires for primary school aged children have traditionally been parent-administered, but self-administered questionnaires would be easier to administer and may yield as good, if not better, information. Our aim was to compare the repeatability of self- and parent-administered indoor air questionnaires designed for primary school aged pupils. Indoor air questionnaire with questions on child's symptoms and perceived indoor air quality in schools was sent to parents of pupils aged 7-12 years in two schools and again after two weeks. Slightly modified version of the questionnaire was administered to pupils aged 9-12 years in another two schools and repeated after a week. 351 (52%) parents and 319 pupils (86%) answered both the first and the second questionnaire. Test-retest repeatability was assessed with intra-class correlation (ICC) and Cohen's kappa coefficients (k). Test-retest repeatability was generally between 0.4-0.7 (ICC; k) in both self- and parent-administered questionnaire. In majority of the questions on symptoms and perceived indoor air quality test-retest repeatability was at the same level or slightly better in self-administered compared to parent-administered questionnaire. Agreement of self- and parent administered questionnaires was generally indoor air quality. Children aged 9-12 years can give as, or even more, repeatable information about their respiratory symptoms and perceived indoor air quality than their parents. Therefore, it may be possible to use self-administered questionnaires in future studies also with children.

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

    Blanes-Vidal, Victoria; Bælum, J; Schwartz, J.

    Background: Adverse health effects of exposure to high levels of air pollutants from biodegradable wastes have been well-studied. However, few investigations have examined effects of chronic exposures to low-to-moderate levels, on health symptoms among residents. Besides, most studies have been...... ecological and did not investigate whether these potential associations were direct or indirect (stress-mediated). Methods: In this study, individual-specific exposures to a proxy indicator of biodegradable waste pollution (ammonia, NH3) in non-urban residences (n=454) during 2005-2010 were calculated...... by the Danish Eulerian long range transport model and the local-scale transport deposition model. Logistic regression and mediating analyses were used to examine associations between exposures and questionnaire- based cross-sectional data on odor annoyance and symptoms, after adjusting by person...

  19. A 12-month follow-up of an influenza vaccination campaign based on voluntary adherence: report on upper-respiratory symptoms among volunteers and non-volunteers

    Páris Ali Ramadan

    Full Text Available CONTEXT: Routine immunization of groups at high risk for influenza has been progressively implemented as a matter of Brazilian public health policy. Although the benefits of the vaccination for healthy young adults are still controversial, it has been offered yearly to hundreds of thousands of Brazilian workers, generally as part of wellness initiatives in the workplace. OBJECTIVE: To study the characteristics of subjects that accepted or refused to be vaccinated against influenza and to report on respiratory symptoms in both groups, one year after the campaign date. DESIGN: A prospective observational study. SETTING: Workers at a subsidiary of an international bank in São Paulo, Brazil. PARTICIPANTS: 124 persons that did not accept and 145 that voluntarily accepted the vaccine completed 12 months of follow-up. MAIN MEASUREMENTS: Data concerning gender, age, tobacco use, and any history of chronic respiratory illness such as asthma, bronchitis, rhinitis, and repetitive upper-respiratory infections, were recorded at the time of vaccination. After that, workers were asked monthly by questionnaire or telephone about respiratory symptoms, days of work lost and medical consultations. RESULTS: The results showed statistically significant differences regarding age (P = 0.004 with the vaccinated group (V being younger than the non-vaccinated (NV one, and with reference to previous repetitive upper-respiratory infections being higher among the V group (P < 0.0001. During the follow-up, the V group reported more occurrences of upper respiratory symptoms (P < 0.0001, due to both non-influenza (P < 0.0001 and influenza-like illness (P = 0.045. Differences were also found between V and NV groups concerning days off work and number of medical consultations due to upper-respiratory symptoms and non-influenza illness. Gender and history of repetitive upper-respiratory infections were the best predictors of influenza-like illness-related events. CONCLUSIONS

  20. Cough-induced rib fractures.

    Hanak, Viktor; Hartman, Thomas E; Ryu, Jay H

    2005-07-01

    To define the demographic, clinical, and radiological features of patients with cough-induced rib fractures and to assess potential risk factors. For this retrospective, single-center study, we identified all cases of cough-induced rib fractures diagnosed at the Mayo Clinic in Rochester, Minn, over a 9-year period between January 1, 1996, and January 31, 2005. Bone densitometry data from patients' medical records were analyzed, and T scores were used to classify patients into bone density categories. The mean +/- SD age of the 54 study patients at presentation was 55+/-17 years, and 42 patients (78%) were female. Patients presented with chest wall pain after onset of cough. Rib fracture was associated with chronic cough (> or =3 weeks' duration) in 85% of patients. Rib fractures were documented by chest radiography, rib radiography, computed tomography, or bone scan. Chest radiography had been performed in 52 patients and revealed rib fracture in 30 (58%). There were 112 fractured ribs in 54 patients. One half of patients had more than one fractured rib. Right-sided rib fractures alone were present in 17 patients (26 fractured ribs), left-sided in 23 patients (35 fractured ribs), and bilateral in 14 patients (51 fractured ribs). The most commonly fractured rib on both sides was rib 6. The fractures were most common at the lateral aspect of the rib cage. Bone densitometry was done in 26 patients and revealed osteopenia or osteoporosis in 17 (65%). Cough-induced rib fractures occur primarily in women with chronic cough. Middle ribs along the lateral aspect of the rib cage are affected most commonly. Although reduced bone density is likely a risk factor, cough-induced rib fractures can occur in the presence of normal bone density.

  1. A causal relationship between cough and gastroesophageal reflux disease (GERD) has been established: a pro/con debate.

    Kahrilas, Peter J; Smith, Jaclyn A; Dicpinigaitis, Peter V

    2014-02-01

    Along with upper airway cough syndrome (formerly, postnasal drip syndrome) and eosinophilic airway inflammation (asthma, nonasthmatic eosinophilic bronchitis), gastroesophageal reflux disease (GERD) is generally considered among the most common etiologies of chronic cough. Indeed, cough management guidelines published by numerous respiratory societies worldwide recommend evaluation and treatment of GERD as an integral component of the diagnostic/therapeutic algorithm for the management of chronic cough. However, a significant number of patients with chronic cough presumed due to GERD do not report improvement despite aggressive acid-suppressive therapy. Some of these refractory cases may be due to the recently appreciated entity of nonacid or weakly acidic reflux. Further contributing to the controversy are recent studies that demonstrate that patients with chronic cough do not have excessive reflux events relative to healthy volunteers. Although a temporal relationship between cough and reflux events has been suggested by studies utilizing impedance-pH monitoring of reflux events and objective cough recording, consensus is lacking in terms of whether this temporal relationship proves a causal link between reflux and cough. The fourth American Cough Conference (New York, June 2013) provided an ideal forum for the debate of this issue between two internationally recognized experts in the field of reflux and chronic cough.

  2. Velocity Field Measurements of Human Coughing Using Time Resolved Particle Image Velocimetry

    Khan, T.; Marr, D. R.; Higuchi, H.; Glauser, M. N.

    2003-11-01

    Quantitative fluid mechanics analysis of human coughing has been carried out using new Time Resolved Particle Image Velocimetry (TRPIV). The study involves measurement of velocity vector time-histories and velocity profiles. It is focused on the average normal human coughing. Some work in the past on cough mechanics has involved measurement of flow rates, tidal volumes and sub-glottis pressure. However, data of unsteady velocity vector field of the exiting highly time-dependent jets is not available. In this study, human cough waveform data are first acquired in vivo using conventional respiratory instrumentation for various volunteers of different gender/age groups. The representative waveform is then reproduced with a coughing/breathing simulator (with or without a manikin) for TRPIV measurements and analysis. The results of this study would be useful not only for designing of indoor air quality and heating, ventilation and air conditioning systems, but also for devising means of protection against infectious diseases.

  3. A probit- log- skew-normal mixture model for repeated measures data with excess zeros, with application to a cohort study of paediatric respiratory symptoms

    Johnston Neil W

    2010-06-01

    Full Text Available Abstract Background A zero-inflated continuous outcome is characterized by occurrence of "excess" zeros that more than a single distribution can explain, with the positive observations forming a skewed distribution. Mixture models are employed for regression analysis of zero-inflated data. Moreover, for repeated measures zero-inflated data the clustering structure should also be modeled for an adequate analysis. Methods Diary of Asthma and Viral Infections Study (DAVIS was a one year (2004 cohort study conducted at McMaster University to monitor viral infection and respiratory symptoms in children aged 5-11 years with and without asthma. Respiratory symptoms were recorded daily using either an Internet or paper-based diary. Changes in symptoms were assessed by study staff and led to collection of nasal fluid specimens for virological testing. The study objectives included investigating the response of respiratory symptoms to respiratory viral infection in children with and without asthma over a one year period. Due to sparse data daily respiratory symptom scores were aggregated into weekly average scores. More than 70% of the weekly average scores were zero, with the positive scores forming a skewed distribution. We propose a random effects probit/log-skew-normal mixture model to analyze the DAVIS data. The model parameters were estimated using a maximum marginal likelihood approach. A simulation study was conducted to assess the performance of the proposed mixture model if the underlying distribution of the positive response is different from log-skew normal. Results Viral infection status was highly significant in both probit and log-skew normal model components respectively. The probability of being symptom free was much lower for the week a child was viral positive relative to the week she/he was viral negative. The severity of the symptoms was also greater for the week a child was viral positive. The probability of being symptom free was

  4. Whooping Cough Vaccine Recommendation for Preteens and Teens

    2015-01-22

    This podcast provides information about whooping cough and the recommendation that all preteens receive the Tdap vaccine when they are 11 or 12 to help protect them from this serious disease.  Created: 1/22/2015 by National Center for Infectious and Respiratory Disease (NCIRD), Division of Bacterial Disease (DBD), Meningitis and Vaccine Preventable Diseases Branch (MVPD).   Date Released: 1/22/2015.

  5. Whooping Cough Vaccine Recommendation for Babies and Young Children

    2015-01-22

    This podcast provides information about whooping cough and the recommendation that all children receive the DTaP vaccine, according to CDC’s recommended schedule, to help protect them from this serious disease.  Created: 1/22/2015 by National Center for Immunization and Respiratory Diseases (NCIRD), Division of Bacterial Diseases (DBD), Meningitis and Vaccine Preventable Diseases Branch (MVPDB).   Date Released: 1/22/2015.

  6. Respiratory health effects associated with restoration work in post-Hurricane Katrina New Orleans.

    Rando, Roy J; Lefante, John J; Freyder, Laurie M; Jones, Robert N

    2012-01-01

    This study examines prevalence of respiratory conditions in New Orleans-area restoration workers after Hurricane Katrina. Between 2007 and 2010, spirometry and respiratory health and occupational questionnaire were administered to 791 New Orleans-area adults who mostly worked in the building construction and maintenance trades or custodial services. The associations between restoration work hours and lung function and prevalence of respiratory symptoms were examined by multiple linear regression, χ², or multiple logistic regression. 74% of participants performed post-Katrina restoration work (median time: 620 hours). Symptoms reported include episodes of transient fever/cough (29%), sinus symptoms (48%), pneumonia (3.7%), and new onset asthma (4.5%). Prevalence rate ratios for post-Katrina sinus symptoms (PRR = 1.3; CI: 1.1, 1.7) and fever and cough (PRR = 1.7; CI: 1.3, 2.4) were significantly elevated overall for those who did restoration work and prevalence increased with restoration work hours. Prevalence rate ratios with restoration work were also elevated for new onset asthma (PRR = 2.2; CI: 0.8, 6.2) and pneumonia (PRR = 1.3; CI: 0.5, 3.2) but were not statistically significant. Overall, lung function was slightly depressed but was not significantly different between those with and without restoration work exposure. Post-Katrina restoration work is associated with moderate adverse effects on respiratory health, including sinusitis and toxic pneumonitis.

  7. Analyzing non-respiratory movements of the chest: methods and devices

    Pariaszewska, Katarzyna; Młyńczak, Marcel; Cybulski, Gerard

    2015-09-01

    Respiration is the main reason of the chest movements. However, there are also non-respiratory ones, resulting from e.g. snoring, wheezing, stridor, throat clearing or coughing. They may exist sporadically, however should be examined in case when their incidences increase. Detecting non-respiratory movements is very important, because many of them are symptoms of respiratory diseases such as asthma, chronic obstructive pulmonary disease (COPD) or lung cancer. Assessment of the presence of non-respiratory movements could be important element of effective diagnosis. It is also necessary to provide quantitative and objective results for intra-subject studies. Most of these events generate vibroacoustic signals that contain components of sound and vibrations. This work provides the review of the solutions and devices for monitoring of the non-respiratory movements, primarily considering the accuracy of the chest movements' detection and distinguishing.

  8. The effect of low-cost modification of the home environment on the development of respiratory symptoms in the first year of life

    Persky, Victoria; Piorkowski, Julie; Hernandez, Eva; Chavez, Noel; Wagner-Cassanova, Cynthia; Freels, Sally; Vergara, Carmen; Pelzel, Darlene; Hayes, Rachel; Gutierrez, Silvia; Busso, Adela; Coover, Lenore; Thorne, Peter S.; Ownby, Dennis

    2010-01-01

    Background Previous studies have suggested that environmental exposures may be related to the development of respiratory symptoms in early life. Intervention studies, however, have not produced consistent findings. Objective The Peer Education in Pregnancy Study examined the effect of home environment intervention with pregnant women at risk for having children with asthma on the development of respiratory symptoms in their infants. Methods A total of 383 pregnant women whose unborn child had a first-degree relative with an allergic history were randomized to 1 of 2 intervention groups, both of whom received general health education, smoking cessation advice, and encouragement to breastfeed. In addition, the intensive education group received 3 home visits focused on home environment modification. Home assessment was performed at baseline and after 1 year of follow-up. Respiratory symptoms were identified during the first year of life. Results Families in both intervention groups showed significant changes in several environmental factors, with significant differences between the 2 groups in insects other than cockroaches, use of mattress covers, and washing in hot water. Children in the intensive education group had slightly lower incidence rates of respiratory symptoms, but few differences were statistically significant. Conclusions The results of this study do not provide strong support for a primary intervention focused on general modification of the home environment during pregnancy for high-risk children. It does not address the effects of more aggressive approaches or of interventions targeting individual environmental factors. PMID:20084841

  9. Effects of Long-Haul Transmeridian Travel on Subjective Jet-Lag and Self-Reported Sleep and Upper Respiratory Symptoms in Professional Rugby League Players.

    Fowler, Peter M; Duffield, Rob; Lu, Donna; Hickmans, Jeremy A; Scott, Tannath J

    2016-10-01

    To examine the effects of 24-h travel west across 11 time zones on subjective jet-lag and wellness responses together with self-reported sleep and upper respiratory symptoms in 18 professional rugby league players. Measures were obtained 1 or 2 d before (pretravel) and 2, 6, and 8 d after travel (post-2, post-6, and post-8) from Australia to the United Kingdom (UK) for the 2015 World Club Series. Compared with pretravel, subjective jet-lag remained significantly elevated on post-8 (3.1 ± 2.3, P 0.90), although it was greatest on post-2 (4.1 ± 1.4). Self-reported sleep-onset times were significantly earlier on post-2 than at all other time points (P 0.90), and large effect sizes suggested that wake times were earlier on post-2 than on post-6 and post-8 (d > 0.90). Although significantly more upper respiratory symptoms were reported on post-6 than at pretravel (P .05, d sleep responses, along with upper respiratory symptoms, in professional rugby league players. Of note, the increase in self-reported upper respiratory symptoms is a reminder that the demands of long-haul travel may be an additional concern in jet-lag for traveling athletes. However, due to the lack of sport-specific performance measures, it is still unclear whether international travel interferes with training to the extent that subsequent competition performance is impaired.

  10. Heavy metals in PM2.5 and in blood, and children's respiratory symptoms and asthma from an e-waste recycling area

    Zeng, Xiang; Xu, Xijin; Zheng, Xiangbin; Reponen, Tiina; Chen, Aimin; Huo, Xia

    This study was to investigate the levels of heavy metals in PM2.5 and in blood, the prevalence of respiratory symptoms and asthma, and the related factors to them. Lead and cadmium in both PM2.5 and blood were significant higher in Guiyu (exposed area) than Haojiang (reference area) (p <0.05),

  11. [PM10 exposure-related respiratory symptoms and disease in children living in and near five coal-mining areas in the Cesar department of Colombia].

    Quiroz-Arcentales, Leonardo; Hernández-Flórez, Luis J; Agudelo Calderón, Carlos A; Medina, Katalina; Robledo-Martínez, Rocío; Osorio-García, Samuel D

    2013-01-01

    Establishing the prevalence of respiratory symptoms and disease in children aged less than 12 years-old living within the Cesar department's coal-mining area and possible associated factors. This was a cross-sectional study of 1,627 children aged less than 10 years-old living in and near coal-mining areas in the Cesar department who were exposed to different levels of PM10 from 2008-2010; their PM10 exposure-related symptoms and respiratory diseases were measured, seeking an association with living in areas exposed to particulate material. Children living in areas close to coal-mining activity which also had high traffic volume had a higher rate of probable cases of asthma; those living in areas with traffic (not no coal-mining) were absent from school for more days due to acute respiratory disease. Respiratory symptoms were most commonly found in children experiencing living conditions which exposed them to cigarette or firewood smoke indoors, living in houses made with wattle and daub or adobe walls, living where animals were kept, living in damp housing and diesel-powered dump trucks operating within 100 m or less of their housing. Living in areas having high traffic volume increased the risk of respiratory symptoms, acute respiratory disease and being absent from school. All the effects studied were associated with intramural conditions, individual factors or those associated with the immediate surroundings thereby coinciding with results found in similar studies regarding air pollution and health. It is thus suggested that regional strategies and policy be created for controlling and monitoring the air quality and health of people living in the Cesar department.

  12. The impact of the environmental and socio-economic factors to the occurrence of symptoms and diseases of the respiratory system in school children from Sosnowiec

    Magda Skiba

    2012-12-01

    Full Text Available Background: Objective of the study was to assess the impact of environmental and socio-economic factors to the occurrence of symptoms and diseases of the respiratory system in school children from Sosnowiec, based on the questionnaire data. Materials and methods: The crosssectional epidemiological questionnaire study was performed in the years 2005–2006. Parents of 709 primary school children aged 7–12 years took part in the study. Questionnaire was completed by parents to collect information on children health status, particularly respiratory symptoms, chronic diseases of respiratory system, allergic diseases, use of medical services, children dietary habits and family socio-economic status. Results: In the study group the statistical significance was found for the incidence of respiratory symptoms in children and housing conditions, i.e.: the number of people sleeping together with a child in the same room and dampness in the dwelling. Results of the study showed, that incidence of whizzing differed statistically significantly in the groups of different professional status of the parents. It is difficult to estimate if this is only the influence of socio-economic conditions or any other environmental factors as well. Conclusions: Results of the study demonstrated statistical significance between the status of respiratory system in children and housing occupancy rate (the number of people sleeping together with a child in the same room and dampness in the dwelling. Relation between respiratory symptoms in children, parents education and professional status was analyzed, but findings of the conducted studies do not give explicit evidence of such a relation.

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

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

    2006-06-15

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

  14. Recognizing flu-like symptoms from videos.

    Thi, Tuan Hue; Wang, Li; Ye, Ning; Zhang, Jian; Maurer-Stroh, Sebastian; Cheng, Li

    2014-09-12

    Vision-based surveillance and monitoring is a potential alternative for early detection of respiratory disease outbreaks in urban areas complementing molecular diagnostics and hospital and doctor visit-based alert systems. Visible actions representing typical flu-like symptoms include sneeze and cough that are associated with changing patterns of hand to head distances, among others. The technical difficulties lie in the high complexity and large variation of those actions as well as numerous similar background actions such as scratching head, cell phone use, eating, drinking and so on. In this paper, we make a first attempt at the challenging problem of recognizing flu-like symptoms from videos. Since there was no related dataset available, we created a new public health dataset for action recognition that includes two major flu-like symptom related actions (sneeze and cough) and a number of background actions. We also developed a suitable novel algorithm by introducing two types of Action Matching Kernels, where both types aim to integrate two aspects of local features, namely the space-time layout and the Bag-of-Words representations. In particular, we show that the Pyramid Match Kernel and Spatial Pyramid Matching are both special cases of our proposed kernels. Besides experimenting on standard testbed, the proposed algorithm is evaluated also on the new sneeze and cough set. Empirically, we observe that our approach achieves competitive performance compared to the state-of-the-arts, while recognition on the new public health dataset is shown to be a non-trivial task even with simple single person unobstructed view. Our sneeze and cough video dataset and newly developed action recognition algorithm is the first of its kind and aims to kick-start the field of action recognition of flu-like symptoms from videos. It will be challenging but necessary in future developments to consider more complex real-life scenario of detecting these actions simultaneously from

  15. Gene editing as a promising approach for respiratory diseases.

    Bai, Yichun; Liu, Yang; Su, Zhenlei; Ma, Yana; Ren, Chonghua; Zhao, Runzhen; Ji, Hong-Long

    2018-03-01

    Respiratory diseases, which are leading causes of mortality and morbidity in the world, are dysfunctions of the nasopharynx, the trachea, the bronchus, the lung and the pleural cavity. Symptoms of chronic respiratory diseases, such as cough, sneezing and difficulty breathing, may seriously affect the productivity, sleep quality and physical and mental well-being of patients, and patients with acute respiratory diseases may have difficulty breathing, anoxia and even life-threatening respiratory failure. Respiratory diseases are generally heterogeneous, with multifaceted causes including smoking, ageing, air pollution, infection and gene mutations. Clinically, a single pulmonary disease can exhibit more than one phenotype or coexist with multiple organ disorders. To correct abnormal function or repair injured respiratory tissues, one of the most promising techniques is to correct mutated genes by gene editing, as some gene mutations have been clearly demonstrated to be associated with genetic or heterogeneous respiratory diseases. Zinc finger nucleases (ZFN), transcription activator-like effector nucleases (TALEN) and clustered regulatory interspaced short palindromic repeats/CRISPR-associated protein 9 (CRISPR/Cas9) systems are three innovative gene editing technologies developed recently. In this short review, we have summarised the structure and operating principles of the ZFNs, TALENs and CRISPR/Cas9 systems and their preclinical and clinical applications in respiratory diseases. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  16. Occupational and Environmental Contributions to Chronic Cough in Adults: Chest Expert Panel Report.

    Tarlo, Susan M; Altman, Kenneth W; Oppenheimer, John; Lim, Kaiser; Vertigan, Anne; Prezant, David; Irwin, Richard S

    2016-10-01

    In response to occupational and environmental exposures, cough can be an isolated symptom reflecting exposure to an irritant with little physiological consequence, or it can be a manifestation of more significant disease. This document reviews occupational and environmental contributions to chronic cough in adults, focusing on aspects not previously covered in the 2006 ACCP Cough Guideline or our more recent systematic review, and suggests an approach to investigation of these factors when suspected. MEDLINE and TOXLINE literature searches were supplemented by articles identified by the cough panel occupational and environmental subgroup members, to identify occupational and environmental aspects of chronic cough not previously covered in the 2006 ACCP Cough Guideline. Based on the literature reviews and the Delphi methodology, the cough panel occupational and environmental subgroup developed guideline suggestions that were approved after review and voting by the full cough panel. The literature review identified relevant articles regarding: mechanisms; allergic environmental causes; chronic cough and the recreational and involuntary inhalation of tobacco and marijuana smoke; nonallergic environmental triggers; laryngeal syndromes; and occupational diseases and exposures. Consensus-based statements were developed for the approach to diagnosis due to a lack of strong evidence from published literature. Despite increased understanding of cough related to occupational and environmental triggers, there remains a gap between the recommended assessment of occupational and environmental causes of cough and the reported systematic assessment of these factors. There is a need for further documentation of occupational and environmental causes of cough in the future. Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

  17. Experience of, awareness of and help-seeking for potential cancer symptoms in smokers and non-smokers: A cross-sectional study.

    Walabyeki, Julie; Adamson, Joy; Buckley, Hannah L; Sinclair, Helena; Atkin, Karl; Graham, Hilary; Whitaker, Katriina; Wardle, Jane; Macleod, Una

    2017-01-01

    Presenting to primary care with potential cancer symptoms is contingent on one's ability to recognize potentially serious symptoms. We investigated differences between smokers and non-smokers in symptoms experienced, awareness and consulting of potential respiratory, head and neck cancer symptoms. Smokers and non-smokers aged over 50 from Yorkshire general practice lists were sent a postal questionnaire asking about symptoms, consulting and awareness of cancer symptoms. Data were analysed using STATA14. Response rate after one reminder was 30.5% (1205/3954). Smoking status was associated with experience of cough (pawareness of breathlessness as a potential cancer symptom (p = 0.035) and consulting for cough (p = 0.011) with smokers less likely to consult than never-smokers (OR = 0.37;95% CI[0.17-0.80]). Our findings suggest that current smokers are more likely to experience cough, breathlessness and tiredness, but are less likely to consult for cough than never-smokers. To increase cancer awareness and promote consulting among smokers, innovative interventions improving symptom recognition and empowering smokers to seek help are required.

  18. An overview of post infectious coughs

    Samrad Mehrabi

    2016-03-01

    Full Text Available Coughs lasting more than 3 weeks after airway infections are likely regarded as post-infectious coughs. A normal chest radiography unfavors possibility of pulmonary infection. These coughs are selflimited. This study reviews conducted studies in order to identify and define prevalence, pathogenesis, and cure of post-infectious constant coughs. The necessary data and guidelines are gained from English articles in PubMed website. Post-infectious and cough are searched. Post-infectious cough pathogenesis are not known; nevertheless, inflammation, epithelial damages of upper and lower airways, increased mucus secretion, and an increased reactivity of airways can cause these coughs. Despite self-limitedness of these coughs; dextromethorphan, antihistamines, ipratropium bromide, and decongestant are usually prescribed for cure of these coughs. Conversely, antibiotics play no significant role in this regard. These coughs constitutes smaller percentage of chronic coughs and are primarily classified in subacute coughs. Further studies should cover sub-acute and chronic properties of these coughs as well as their prevalence in different age groups and their determinants.

  19. Respiratory Symptoms in Hospital Cleaning Staff Exposed to a Product Containing Hydrogen Peroxide, Peracetic Acid, and Acetic Acid

    Hawley, Brie; Casey, Megan; Virji, Mohammed Abbas; Cummings, Kristin J.; Johnson, Alyson; Cox-Ganser, Jean

    2017-01-01

    with increased exposure to the oxidant mixture (P = 0.017), as well as the TM (P = 0.026). Our results suggest that exposure to a product containing HP, PAA, and AA contributed to eye and respiratory symptoms reported by hospital cleaning staff at low levels of measured exposure. PMID:29077798

  20. Respiratory Symptoms in Hospital Cleaning Staff Exposed to a Product Containing Hydrogen Peroxide, Peracetic Acid, and Acetic Acid.

    Hawley, Brie; Casey, Megan; Virji, Mohammed Abbas; Cummings, Kristin J; Johnson, Alyson; Cox-Ganser, Jean

    2017-12-15

    with increased exposure to the oxidant mixture (P = 0.017), as well as the TM (P = 0.026). Our results suggest that exposure to a product containing HP, PAA, and AA contributed to eye and respiratory symptoms reported by hospital cleaning staff at low levels of measured exposure. Published by Oxford University Press on behalf of the British Occupational Hygiene Society 2017.

  1. A Cough-Based Algorithm for Automatic Diagnosis of Pertussis

    Pramono, Renard Xaviero Adhi; Imtiaz, Syed Anas; Rodriguez-Villegas, Esther

    2016-01-01

    Pertussis is a contagious respiratory disease which mainly affects young children and can be fatal if left untreated. The World Health Organization estimates 16 million pertussis cases annually worldwide resulting in over 200,000 deaths. It is prevalent mainly in developing countries where it is difficult to diagnose due to the lack of healthcare facilities and medical professionals. Hence, a low-cost, quick and easily accessible solution is needed to provide pertussis diagnosis in such areas to contain an outbreak. In this paper we present an algorithm for automated diagnosis of pertussis using audio signals by analyzing cough and whoop sounds. The algorithm consists of three main blocks to perform automatic cough detection, cough classification and whooping sound detection. Each of these extract relevant features from the audio signal and subsequently classify them using a logistic regression model. The output from these blocks is collated to provide a pertussis likelihood diagnosis. The performance of the proposed algorithm is evaluated using audio recordings from 38 patients. The algorithm is able to diagnose all pertussis successfully from all audio recordings without any false diagnosis. It can also automatically detect individual cough sounds with 92% accuracy and PPV of 97%. The low complexity of the proposed algorithm coupled with its high accuracy demonstrates that it can be readily deployed using smartphones and can be extremely useful for quick identification or early screening of pertussis and for infection outbreaks control. PMID:27583523

  2. Respiratory Syncytial Virus Bronchiolitis in Children.

    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.

  3. [Serological evaluation of Bordetella pertussis infection in adults with prolonged cough].

    Sönmez, Cemile; Çöplü, Nilay; Gözalan, Ayşegül; Yılmaz, Ülkü; Bilekli, Selen; Demirci, Nilgün Yılmaz; Biber, Çiğdem; Erdoğan, Yurdanur; Esen, Berrin; Çöplü, Lütfi

    2016-07-01

    Pertussis is a vaccine-preventable disease that is transmitted from infected to susceptible individuals by respiratory route. Bordetella pertussis infection may occur at any age as neither vaccine nor natural infection induced immunity lasts life-long. This study was planned to demonstrate the serological evidence of infection among adults, to raise awareness among clinicians and to provide data for the development of strategies to protect vulnerable infants. A total of 538 patients (345 female, 193 male) ages between 18-87 years who had a complain of prolonged cough for more than two weeks were included in the study. Anti-pertussis toxin (PT) IgG and anti-filamentous hemagglutinin (FH) IgG levels from single serum samples were measured by an in-house ELISA test which was standardized and shown to be efficient previously. Anti-PT IgG antibody levels of ≥ 100 EU/ml were considered as acute/recent infection with B.pertussis. In our study, 9.7% (52/538) of the patients had high levels of anti-PT IgG (≥ 100 EU/ml) and among those patients 43 (43/52; 82.7%) also had high (≥ 100 EU/ml) anti-FHA IgG levels. There were no statistically significant differences in terms of age, gender, education level, DPT (diphtheria-pertussis-tetanus) vaccination history, smoking history or average daily cigarette consumption (p> 0.05) between the cases with high antibody levels (n= 52). When the symptoms and the presence of cases with high antibody levels were evaluated, it was detected that no one parameter was significantly different from others, except that 24.1% of the cases with inspiratory whooping had high anti-PT levels. There was also no statistically significant difference between high anti-PT levels ≥ 100 EU/ml and the patients with risk factors [smoking (21/200; 10.5%), presence of disease that cause chronic cough and/or drug usage (19/171; %11.1), and whole factors which cause chronic cough (32/306; %10.5)] and without risk factors (p= 0.581; p= 0.357; p= 0

  4. Exposure to secondhand smoke from neighbours and respiratory symptoms in never-smoking adolescents in Hong Kong: a cross-sectional study.

    Leung, Lok Tung; Ho, Sai Yin; Wang, Man Ping; Lo, Wing Sze; Lam, Tai Hing

    2015-11-04

    To investigate secondhand smoke (SHS) exposure at home from neighbours in Hong Kong adolescents and its association with respiratory symptoms in never-smokers. A cross-sectional study. 79 randomly selected secondary schools in Hong Kong. 61,810 secondary 1 (USA grade 7) to 7 students, in which 50,762 never-smokers were identified and included in the analysis of the association between SHS exposure at home from neighbours and respiratory symptoms. Smoking status, family smoking status, SHS exposure at home from inside the home and from neighbours in the past 7 days, respiratory symptoms and sociodemographic characteristics were reported. Adjusted ORs (AORs) of respiratory symptoms for SHS exposure from the 2 sources in never-smokers were calculated using logistic regression. In all students, 33.2% were exposed to SHS at home, including 16.2% from inside the home only, 10.0% from neighbours only and 7.0% from both. The prevalence of SHS exposure from neighbours was 17.1%, including 13.5% for 1-4 days/week and 3.6% for 5-7 days/week. In never-smokers (n=50,762), respiratory symptoms were significantly associated with SHS exposure from neighbours with AORs (95% CI) of 1.29 (1.20 to 1.39) for any exposure (pexposure at home from any source, the AORs were 1.16 (1.07 to 1.25) for SHS from inside the home only (pexposure at home from neighbours was prevalent in Hong Kong adolescents, and was associated with respiratory symptoms in never-smokers. SHS exposure at home may be underestimated by ignoring the neighbouring source. Smoke-free housing policy is needed to protect children and adolescents from harms of SHS. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  5. Immunoglobulin E-mediated sensitization to pine and beech dust in relation to wood dust exposure levels and respiratory symptoms in the furniture industry.

    Schlünssen, Vivi; Kespohl, Sabine; Jacobsen, Gitte; Raulf-Heimsoth, Monika; Schaumburg, Inger; Sigsgaard, Torben

    2011-03-01

    Wood dust exposure may cause Immunoglobulin E (IgE)-mediated allergic diseases. Our objectives were to estimate pine and beech dust sensitization rates among woodworkers and a reference group, explore the association between exposure and sensitization and between sensitization and respiratory symptoms, and finally investigate the impact of proteinogenic specific IgE (sIgE) epitopes on respiratory symptoms. In a Danish study among 52 furniture factories and 2 reference factories, we evaluated the workers' asthma and rhinitis status using questionnaires and blood samples collected from 1506 woodworkers and 195 references. Workers with asthma symptoms (N=298), a random study sample (N=399) and a random rhinitis sample (N=100) were evaluated for IgE-mediated sensitization to pine and beech dust. The prevalence of pine and beech sensitization among current woodworkers was 1.7 and 3.1%, respectively. No differences in sensitization rates were found between woodworkers and references, but the prevalence of wood dust sensitization was dose-dependently associated with the current level of wood dust exposure. No relation was observed between wood dust sensitization per se and respiratory symptoms. Only symptomatic subjects had proteinogenic IgE epitopes to pine. Increased odds ratios for sIgE based on proteinogenic epitopes to beech and respiratory symptoms were found, although they were not statistically significant. Sensitization rates to pine and beech were the same for woodworkers and references but dependent on the current wood dust exposure level. The importance of beech and pine wood sensitization is limited, but may be of clinical significance for a few workers if the IgE epitopes are proteinogenic.

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

    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

  7. Diet Pattern and Respiratory Morbidity in the Atherosclerosis Risk in Communities Study.

    Brigham, Emily P; Steffen, Lyn M; London, Stephanie J; Boyce, Danielle; Diette, Gregory B; Hansel, Nadia N; Rice, Jessica; McCormack, Meredith C

    2018-02-15

    Dietary intake is a potential risk factor for respiratory morbidity in adult populations. Few studies capture the effect of diet patterns, representative of combination of nutrients consumed, on respiratory morbidity in combination with objective measures of lung function. To evaluate patterns of dietary intake in relation to respiratory morbidity and objective measures of lung function in a U.S. The Atherosclerosis Risk in Communities (ARIC) Study enrolled 15,792 participants from four U.S. communities between 1987-1989 and collected a validated food frequency questionnaire to assess diet. Principal components analysis was applied and patterns representative of "Western" and "Prudent" diet emerged. We investigated associations between dietary pattern and pulmonary assessments including asthma and chronic obstructive pulmonary disease (COPD) diagnosis, respiratory symptoms, and lung function. Multivariable logistic regression models included quintiles of dietary patterns and potential confounders. Interaction of dietary patterns with obesity, gender, and smoking status was assessed in relation to all outcomes. A "Western" diet pattern was associated with higher odds of COPD, wheeze, cough, phlegm, and worse lung function, whereas a "Prudent" diet pattern was associated with lower odds of COPD, cough, and better lung function. The prevalence of asthma was not related to dietary intake. Dietary pattern was significantly associated with respiratory outcomes in ARIC participants. A "Western" diet was adverse, whereas a "Prudent" diet was beneficially related to respiratory morbidity and objective measures of lung function. Additional studies of dietary pattern in U.S. populations are needed to verify this effect.

  8. Suppression of the cough reflex by α2-adrenergic receptor agonists in the rabbit

    Cinelli, Elenia; Bongianni, Fulvia; Pantaleo, Tito; Mutolo, Donatella

    2013-01-01

    The α2-adrenergic receptor agonist clonidine has been shown to inhibit citric acid-induced cough responses in guinea pigs when administered by aerosol, but not orally. In contrast, oral or inhaled clonidine had no effect on capsaicin-induced cough and reflex bronchoconstriction in humans. In addition, intravenous administration of clonidine has been shown to depress fentanyl-induced cough in humans. We investigated the effects of the α2-adrenergic receptor agonists, clonidine and tizanidine, on cough responses induced by mechanical and chemical (citric acid) stimulation of the tracheobronchial tree. Drugs were microinjected (30–50 nL) into the caudal nucleus tractus solitarii (cNTS) and the caudal ventral respiratory group (cVRG) as well as administered intravenously in pentobarbital sodium-anesthetized, spontaneously breathing rabbits. Bilateral microinjections of clonidine into the cNTS or the cVRG reduced cough responses at 0.5 mmol/L and abolished the cough reflex at 5 mmol/L. Bilateral microinjections of 0.5 mmol/L tizanidine into the cNTS completely suppressed cough responses, whereas bilateral microinjections of 5 mmol/L into the cVRG only caused mild reductions in them. Depressant effects on the cough reflex of clonidine and tizanidine were completely reverted by microinjections of 10 mmol/L yohimbine. Intravenous administration of clonidine (80–120 μg/kg) or tizanidine (150–300 μg/kg) strongly reduced or completely suppressed cough responses. These effects were reverted by intravenous administration of yohimbine (300 μg/kg). The results demonstrate that activation of α2-adrenergic receptors in the rabbit exerts potent inhibitory effects on the central mechanism generating the cough motor pattern with a clear action at the level of the cNTS and the cVRG. PMID:24400133

  9. Diagnostic aid to rule out pneumonia in adults with cough and feeling of fever. A validation study in the primary care setting

    Held Ulrike

    2012-12-01

    Full Text Available Abstract Background We recently reported the derivation of a diagnostic aid to rule out pneumonia in adults presenting with new onset of cough or worsening of chronic cough and increased body temperature. The aim of the present investigation was to validate the diagnostic aid in a new sample of primary care patients. Methods From two group practices in Zurich, we included 110 patients with the main symptoms of cough and subjective feeling of increased body temperature, and C-reactive protein levels below 50 μg/ml, no dyspnea, and not daily feeling of increased body temperature since the onset of cough. We excluded patients who were prescribed antibiotics at their first consultation. Approximately two weeks after inclusion, practice assistants contacted the participants by phone and asked four questions regarding the course of their complaints. In particular, they asked whether a prescription of antibiotics or hospitalization had been necessary within the last two weeks. Results In 107 of 110 patients, pneumonia could be ruled out with a high degree of certainty, and no prescription of antibiotics was necessary. Three patients were prescribed antibiotics between the time of inclusion in the study and the phone interview two weeks later. Acute rhinosinusitis was diagnosed in one patient, and antibiotics were prescribed to the other two patients because their symptoms had worsened and their CRP levels increased. Use of the diagnostic aid could have missed these two possible cases of pneumonia. These observations correspond to a false negative rate of 1.8% (95% confidence interval: 0.50%-6.4%. Conclusions This diagnostic aid is helpful to rule out pneumonia in patients from a primary care setting. After further validation application of this aid in daily practice may help to reduce the prescription rate of unnecessary antibiotics in patients with respiratory tract infections.

  10. Cough Variant Asthma in Medical Outpatient Department of a Tertiary Care Hospital in Bangladesh

    Rukhsana Parvin

    2013-01-01

    Full Text Available Background: Cough variant asthma (CVA is a subset of asthma where the only symptom is chronic persistent cough. Many cases go unrecognized due to lack of proper evaluation. Response to asthma medication with features supportive of airway hypersensitivity helps in management of this disease. Objective: To find out the proportion of cough variant asthma among the patients attending medicine outpatient department of Enam Medical College, Savar, Dhaka. Materials and Methods: This cross sectional study was conducted in Enam Medical College Hospital, Savar, Dhaka over a period of two years from July 2009 to July 2011. Cough variant asthma was diagnosed mainly on clinical ground as chronic cough without wheezing, fever, weight loss, shortness of breath or sputum or any other apparent cause that persisted for more than eight weeks with absolutely normal physical examination of chest, normal chest radiography and blood count except raised eosinophil count and IgE level. Patients who met these criteria were given 2 weeks course of inhaler beclomethasone propionate and were assessed for improvement. Those who improved after steroid inhalation were categorised as having cough variant asthma. Results: Out of purposively selected 148 patients complaining only of chronic dry cough for more than eight weeks, 92 patients met the primary selection criteria for cough variant asthma. These 92 patients were given 2 weeks trial of 250 ìgm beclomethasone inhalation twice daily. Seventy nine patients reported almost complete recovery from chronic cough after 2 weeks and were categorized as having CVA. Thirteen patients did not improve and were not categorized as CVA. Conclusion: These findings suggest that cough variant asthma is the most common among the patients with chronic cough not due to any apparent cause. The efficacy of inhaled corticosteroid suggests that early intervention is effective in the treatment of this disease.

  11. Incidencia de síntomas respiratorios y su asociación con contaminación atmosférica en preescolares: un análisis multinivel Incidence of respiratory symptoms and the association with air pollution in preschoolers: a multilevel analysis

    Laura Andrea Rodríguez Villamizar

    2010-07-01

    Full Text Available El objetivo del estudio fue determinar la asociación entre contaminación atmosférica y el desarrollo de síntomas respiratorios en preescolares de Bucaramanga, Colombia. Se realizó un estudio de cohorte durante un año, registrando síntomas en preescolares residentes en dos zonas de la ciudad con mediciones extremas de PM10 y se ajustó por variables individuales y residenciales con un modelo multinivel. Se siguieron 707 preescolares. El estornudo y la tos con flemas fueron los síntomas más frecuentes con tasas de incidencia de 277,2 y 203,3 eventos por 100 niños-mes en riesgo. En la zona de mayor contaminación, un incremento de 10µg/m³ en la concentración atmosférica de PM10 incrementó en 1,3 el número de síntomas diarios reportados. El análisis multinivel mostró ausencia de asociación entre PM10 y síntomas respiratorios y que la historia de asma, la exposición a alto flujo vehicular frente a la vivienda, la presencia de animales domésticos y de suelos de tierra, son las variables que tienen mayor efecto sobre la presencia de síntomas en esta población de preescolares.The aim of this study was to evaluate the association between air pollution and respiratory symptoms in preschoolers from Bucaramanga, Colombia. A cohort study was conducted by reporting daily symptoms in preschoolers living in two zones of the city with different PM10 air pollution levels. Individual and neighborhood variables were included in a multilevel analysis. In 707 preschoolers followed for a year, sneezing and cough with mucus were the most frequent symptoms, with incidence rates of 277.2 and 203.3 events per 100 child months at risk. In the high pollution zone, an increase of 10µg/m3 in PM10 concentration increased the reporting of daily symptoms by 1.3. Multilevel analysis showed no statistical association between PM10 and respiratory symptoms, but asthma history, heavy traffic in front of the residence, presence of domestic pets, and dirt

  12. [Features of Bordetella pertussis, Bordetella spp. infection and whopping cough in Córdoba province, Argentina].

    Giayetto, Víctor O; Blanco, Sebastián; Mangeaud, Arnaldo; Barbás, María G; Cudolá, Analía; Gallego, Sandra V

    2017-04-01

    Whooping cough is a re-emerging infection in the world and Latin America. It was considered relevant to investigate the clinical and epidemiological profile of Bordetella spp. and Bordetella pertussis infection in Córdoba province, Argentina; evaluating, at the same time, the co-infection with virus producing respiratory infections that may be confused with whooping cough. All whooping cough suspected cases were studied by Polimerase Chain Reaction, amplifying the repeated insertion sequence (IS) 481 and the promoter gene encoding pertussis toxin, between 2011 and 2013. The data were obtained from the clinical and epidemiological records. From 2,588 whooping cough suspected cases, 11.59% was infected by Bordetella spp. and 9.16% was confirmed as Bordetella pertussis infection. The rate of infection was 7.22 and 1.84 per 100,000 for 2011 and 2012, respectively. The infection presented a seasonal tendency and it was mainly found on the group of children between 13 and 24 months old. The co-infection with virus producing respiratory infections, were uncommon. Paroxysmal cough, cyanosis and/or vomiting were predictors of the infection for Bordetella pertussis. To deal with the re-emergence of whooping cough is important the knowledge of the regional epidemiological situation. This paper shows the situation of these infections in the regional clinical and epidemiological context, and makes the information available for health decision-making.

  13. Ineffective cough and mechanical mucociliary clearance techniques.

    Fernández-Carmona, A; Olivencia-Peña, L; Yuste-Ossorio, M E; Peñas-Maldonado, L

    Cough is a fundamental defense mechanism for keeping the airway free of foreign elements. Life-threatening situations may arise when cough proves ineffective as a result of muscle weakness or altered mucociliary function. When a patient is unable to cough effectively, techniques are required to either reinforce or replace cough capacity. The use of mechanical systems that facilitate or substitute cough function is increasingly common in Intensive Care Units, where it is relatively frequent to find situations of ineffective cough due to different clinical causes. This review examines the current clinical practice recommendations referred to the indication and use of mechanical cough assist and intrapulmonary percussive ventilation systems. Copyright © 2017 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

  14. Successful use of guanfacine in a patient with chronic refractory cough: A case report

    Gregory W. Kirschen

    2017-01-01

    Full Text Available Chronic idiopathic cough is a common and often frustrating complaint for patients as well as providers. When common etiologies of cough are ruled out and/or do not respond to usual treatments, neurogenic cough should be considered as a diagnosis of exclusion. Here, we report on a 58-year-old woman with an 8-year history of chronic, treatment-refractory cough of unknown etiology that we diagnosed as neurogenic cough and successfully treated with guanfacine monotherapy, with rapid and durable improvement in symptoms. This case was particularly challenging for a number of reasons, including a distant past smoking history and previous pneumonia, a significant psychiatric history, and a mildly deviated nasal septum and nasal osteophyte, all or some of which could have contributed to the etiology of the cough. This case illustrates that neurogenic cough should be a diagnostic consideration in patients presenting with chronic cough in whom other treatment modalities have failed, and also suggests that the therapeutic use of guanfacine in this clinical setting warrants future investigation.

  15. Voluntary Cough Production and Swallow Dysfunction in Parkinson’s Disease

    Bolser, Donald; Rosenbek, John; Troche, Michelle; Sapienza, Christine

    2014-01-01

    Cough is important for airway clearance, particularly if penetration/aspiration of foreign material occurs during swallow. Measures of voluntary cough production from ten male participants with stage II–III Parkinson’s disease (PD) who showed no videofluorographic evidence of penetration/aspiration (Group 1) were examined and compared with those of ten male participants with stage II–III PD who showed videofluorographic evidence of penetration/aspiration (Group 2). The degree of penetration/ aspiration was expertly judged from the videofluorographic examinations of the participants’ sequential swallow of a thin, 30-cc bolus. Measured cough parameters included inspiratory phase duration, inspiratory peak flow, compression phase duration, expiratory peak flow, expiratory rise time, and cough volume acceleration. Results indicated significant group differences for the majority of cough measures, except for inspiratory phase duration and inspiratory peak flow. A modest relationship existed between voluntary cough parameters and penetration/aspiration scores. Decreased ability to adequately clear material from the airway with voluntary cough may exacerbate symptoms resulting from penetration/aspiration, particularly for those with neurodegenerative disease. Measurement of voluntary cough may be useful for the evaluation of airway clearance ability. PMID:18483823

  16. Coordination of cough and swallow: a meta-behavioral response to aspiration.

    Pitts, Teresa; Rose, Melanie J; Mortensen, Ashley N; Poliacek, Ivan; Sapienza, Christine M; Lindsey, Bruce G; Morris, Kendall F; Davenport, Paul W; Bolser, Donald C

    2013-12-01

    Airway protections is the prevention and/or removal of material by behaviors such as cough and swallow. We hypothesized these behaviors are coordinated to respond to aspiration. Anesthetized animals were challenged with simulated aspiration that induced both coughing and swallowing. Electromyograms of upper airway and respiratory muscles together with esophageal pressure were recorded to identify and evaluate cough and swallow. During simulated aspiration, both cough and swallow intensity increased and swallow duration decreased consistent with rapid pharyngeal clearance. Phase restriction between cough and swallow was observed; swallow was restricted to the E2 phase of cough. These results support three main conclusions: 1) the cough and swallow pattern generators are tightly coordinated so as to generate a protective meta-behavior; 2) the trachea provides feedback on swallow quality, informing the brainstem about aspiration incidences; and 3) the larynx and upper esophageal sphincter act as two separate valves controlling the direction of positive and negative pressures from the upper airway into the thorax. Copyright © 2013 Elsevier B.V. All rights reserved.

  17. Respiratory Infections and Antibiotic Usage in Common Variable Immunodeficiency.

    Sperlich, Johannes M; Grimbacher, Bodo; Workman, Sarita; Haque, Tanzina; Seneviratne, Suranjith L; Burns, Siobhan O; Reiser, Veronika; Vach, Werner; Hurst, John R; Lowe, David M

    Patients with common variable immunodeficiency (CVID) suffer frequent respiratory tract infections despite immunoglobulin replacement and are prescribed significant quantities of antibiotics. The clinical and microbiological nature of these exacerbations, the symptomatic triggers to take antibiotics, and the response to treatment have not been previously investigated. To describe the nature, frequency, treatment, and clinical course of respiratory tract exacerbations in patients with CVID and to describe pathogens isolated during respiratory tract exacerbations. We performed a prospective diary card exercise in 69 patients with CVID recruited from a primary immunodeficiency clinic in the United Kingdom, generating 6210 days of symptom data. We collected microbiology (sputum microscopy and culture, atypical bacterial PCR, and mycobacterial culture) and virology (nasopharyngeal swab multiplex PCR) samples from symptomatic patients with CVID. There were 170 symptomatic exacerbations and 76 exacerbations treated by antibiotics. The strongest symptomatic predictors for commencing antibiotics were cough, shortness of breath, and purulent sputum. There was a median delay of 5 days from the onset of symptoms to commencing antibiotics. Episodes characterized by purulent sputum responded more quickly to antibiotics, whereas sore throat and upper respiratory tract symptoms responded less quickly. A pathogenic virus was isolated in 56% of respiratory exacerbations and a potentially pathogenic bacteria in 33%. Patients with CVID delay and avoid treatment of symptomatic respiratory exacerbations, which could result in structural lung damage. However, viruses are commonly represented and illnesses dominated by upper respiratory tract symptoms respond poorly to antibiotics, suggesting that antibiotic usage could be better targeted. Copyright © 2017 American Academy of Allergy, Asthma & Immunology. All rights reserved.

  18. Evaluation of etiology of chronic cough in children

    Yasin Yildiz

    2017-03-01

    Conclusion: The patients who was admitted with chronic cough should be questioned in history for exposure to smoke, nutrition, atopy in the family and postnasal drip, the length of expiration, wheezing like symptoms should be examined in physical examination. Thus, by preventing the delay in the diagnosis of patients with stage the rates of unnecessary diagnostic procedures will be reduced. Also we would be able to prevent the excessive use of drugs. [Cukurova Med J 2017; 42(1.000: 66-72

  19. [Respiratory infections caused by respiratory syncytial virus in the adult population: description of 16 cases].

    Reina, Jordi; López, Carla

    2013-08-17

    Respiratory infections of viral etiology are frequent in the adult population. Those caused by respiratory syncytial virus (RSV) are a little known entity. The aim of this study was to determine the clinical and epidemiological characteristics of adult patients with respiratory infection due to RSV. We performed a prospective study from October 2012 to March 2013 on respiratory infections caused by RSV. Viral detection was performed using a technique of reverse transcription polymerase chain reaction genomic amplification in real time. We diagnosed 16 patients, 12 (75%) requiring hospitalization. Patients were grouped into immunocompromised (7 [43.7%]) and immunocompetent cases (9 cases 56.3%]). The first group included 3 patients with HIV infection (42.8%) and 4 hematologic patients (57.2%). The second group included those who had a baseline disease, 5 cases (55.5%), and those who lacked it, 4 cases (44.4%), and did not require hospitalization. The main clinical manifestations of patients prompting them to attend the Emergency Department were cough (50%), dyspnea (43.5%), fever (25%), expectoration (25%) and flu symptoms (25%). The most frequent diagnoses at discharge were pneumonia (37.5%) and flu syndrome (31.2%). Respiratory infections caused by RSV represent a rare condition that mainly affects immunocompromised patients. The underlying pathology determines the evolution of the process, which is favorable except in cases of severe immunosuppression. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  20. Effects of air pollution and seasonality on the respiratory symptoms and health-related quality of life (HR-QoL) of outpatients with chronic respiratory disease in Ulaanbaatar: pilot study for the comparison of the cold and warm seasons.

    Nakao, Motoyuki; Yamauchi, Keiko; Ishihara, Yoko; Solongo, Bandi; Ichinnorov, Dashtseren

    2016-01-01

    This study was performed to investigate the effects of air pollution and seasonality on the respiratory symptoms and health-related quality of life (HR-QoL) of outpatients with respiratory diseases in Ulaanbaatar, Mongolia. Subjects were outpatients who visited the hospital with chronic obstructive pulmonary diseases (COPD) or bronchial asthma (BA) in March. Their symptoms and HR-QoL were evaluated using a questionnaire including the SF-36v2 and COOP/WONCA charts in March, May and July. PM2.5 was sampled in March and July in Ulaanbaatar, and its composition was analyzed. Patients with COPD or BA showed higher prevalence of respiratory symptoms than the control subjects in each month. For HR-QoL, all subscales worsened in the patients than in the control group in March. Although the HR-QoL of the COPD and control groups were not significantly changed through the surveys, some subscales of the BA group showed remarkable improvement in July as compared to March. Daily means of PM2.5 in March were significantly higher than those in July. Carbon and ionic component concentrations, except for magnesium and calcium ions, were significantly higher in March than July. Mass concentrations of some metallic components were also significantly higher in March than July. The percentage of nitrate ion in PM2.5 was significantly higher in March when compared to that in July. These results suggested that the symptoms in the COPD and BA groups were caused by the disease, and the association with air pollution or seasonality remained unclear. However, the effects of air pollution and seasonality on the HR-QoL were significant in the patients with BA.

  1. Analysing the causes of chronic cough: relation to diesel exhaust, ozone, nitrogen oxides, sulphur oxides and other environmental factors

    Wagner Ulrich

    2006-05-01

    Full Text Available Abstract Air pollution remains a leading cause of many respiratory diseases including chronic cough. Although episodes of incidental, dramatic air pollution are relatively rare, current levels of exposure of pollutants in industrialized and developing countries such as total articles, diesel exhaust particles and common cigarette smoke may be responsible for the development of chronic cough both in children and adults. The present study analyses the effects of common environmental factors as potential causes of chronic cough. Different PubMed-based researches were performed that related the term cough to various environmental factors. There is some evidence that chronic inhalation of diesel can lead to the development of cough. For long-term exposure to nitrogen dioxide (NO2, children were found to exhibit increased incidences of chronic cough and decreased lung function parameters. Although a number of studies did not show that outdoor pollution directly causes the development of asthma, they have demonstrated that high levels pollutants and their interaction with sunlight produce ozone (O3 and that repeated exposure to it can lead to chronic cough. In summary, next to the well-known air pollutants which also include particulate matter and sulphur dioxide, a number of other indoor and outdoor pollutants have been demonstrated to cause chronic cough and therefore, environmental factors have to be taken into account as potential initiators of both adult and pediatric chronic cough.

  2. Comparison of the Effect of Two Kinds of Iranian Honey and Diphenhydramine on Nocturnal Cough and the Sleep Quality in Coughing Children and Their Parents.

    Parviz Ayazi

    Full Text Available Coughing in a child induced by upper respiratory tract infections (URTIs can be a problem, both for the child and its parents. Current studies show a lack of proven efficacy for over-the counter (OTC medications, but promising data support the use of honey for children. The aim of this study was to compare the effects of two kinds of Iranian honey with diphenhydramine (DPH on nocturnal pediatric coughs and the sleep quality of children and their parents. This was a clinical trial (registered in IRCT; No.: 28.20.7932, 15 October 2013. The study consisted of 87 patients. All the parents completed a standard previously validated questionnaire. The children were randomly assigned to one of three treatment groups: Group 1, Honey type 1 (Kimia Company, Iran (n = 42, Group 2, Honey type 2 (Shahde-Golha, Iran (n = 25, and Group 3, DPH (n = 20. Each group received double doses of the respective treatments on two successive nights. A second survey was then administered via a telephone interview in which the parents were asked the same questions. The mean scores for all aspects of coughs were significantly decreased in each group before and after the treatment. All three treatments improved the cough and sleep scores. Honey type 1 was superior to DPH in improving all aspects of coughs, except the frequency, and Honey type 2 was more effective than DPH in improving all aspects of coughs, except the sleep quality of the child. There was no significant difference between Honey type 1 and 2 in any aspects of cough relief in the present study. The results suggest that honey may provide better cough relief than DPH in children and improve the sleep quality of children and their parents.

  3. Cough reflex sensitization from esophagus and nose.

    Hennel, Michal; Brozmanova, Mariana; Kollarik, Marian

    2015-12-01

    The diseases of the esophagus and nose are among the major factors contributing to chronic cough although their role in different patient populations is debated. Studies in animal models and in humans show that afferent C-fiber activators applied on esophageal or nasal mucosa do not initiate cough, but enhance cough induced by inhaled irritants. These results are consistent with the hypothesis that activation of esophageal and nasal C-fibers contribute to cough reflex hypersensitivity observed in chronic cough patients with gastroesophageal reflux disease (GERD) and chronic rhinitis, respectively. The afferent nerves mediating cough sensitization from the esophagus are probably the neural crest-derived vagal jugular C-fibers. In addition to their responsiveness to high concentration of acid typical for gastroesophageal reflux (pH acidic reflux such as receptors highly sensitive to acid and receptors for bile acids. The nature of sensory pathways from the nose and their activators relevant for cough sensitization are less understood. Increased cough reflex sensitivity was also reported in many patients with GERD or rhinitis who do not complain of cough indicating that additional endogenous or exogenous factors may be required to develop chronic coughing in these diseases. Copyright © 2015 Elsevier Ltd. All rights reserved.

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

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

    2016-04-01

    This longitudinal study examined the prospective contribution of respiratory sinus arrhythmia (RSA), a key physiological indicator of self-regulation, to eating disorder symptoms in college students, and whether this link was moderated by maladaptive responses to stress and parent psychological control. At Wave 1, college students' RSA was measured at rest. At Waves 1 and 2 (six-month follow-up), students reported on their eating disorder symptoms, coping and involuntary responses to stress, and perceptions of their parents' use of psychological control. Significant three-way interactions indicated that the link between RSA and subsequent eating disorder symptoms was contingent on responses to stress and parent psychological control. In the context of maladaptive responses to stress and high psychological control, RSA predicted increased eating disorder symptoms over time. In the absence of parent psychological control, high RSA was beneficial in most cases, even when individuals reported maladaptive responses to stress. This study presents novel evidence that high RSA contributes to risk for or resilience to eating disorder symptoms over time. RSA can be protective against eating disorder symptoms, but in some contexts, the self-regulation resources that high RSA provides may be inappropriately applied to eating cognitions and behaviors. This research highlights the importance of examining physiological functioning conjointly with other risk factors as precursors to eating disorder symptoms over time. Copyright © 2016. Published by Elsevier Ltd.

  5. STUDY ON CAMPHOR-FREE NATURAL TOPICAL MEDICINE FOR UPPER RESPIRATORY TRACT INFECTIONS IN CHILDREN

    Zubair Ali

    2016-12-01

    Full Text Available Upper respiratory tract infections (URTI are the most common acute illnesses that are often of viral origin. Cough and chest congestion are the common symptoms of this disease. Children are prescribed with drugs that are considered to relive the symptoms of this disease. The topical medications contain vegetable camphor for more than a century that relieve chest congestion and cough caused by URTI. The use of camphor in such products remains questionable especially in children who are more sensitive to its side effects. Herbion “Chest Rub” for children is a camphor-free formulation that contains eucalyptus oil mixture, menthol,turpentine and clove oils and is used to relieve symptoms of URTI.The objective of the present investigationwas to determine the effectiveness of the chest rub inchildren suffering with congestion and cough caused by URTI. The study compared the results of the chest rub applied to a group of infected children with a placebo group. Patients were selected randomly on the basis of the criteria set for the study. The results indicated that the chest rub was quite effective in majority of the cases in relieving the symptoms of URTI as compared to the placebo group.

  6. [Automatic Classification of Dry Cough and Wet Cough Based on Improved Reverse Mel Frequency Cepstrum Coefficients].

    Zhu, Chunmei; Liu, Baojun; Li, Ping; Mo, Hongqiang; Zheng, Zeguang

    2016-04-01

    Automatic classification of different types of cough plays an important role in clinical.In the previous research of cough classification or cough recognition,traditional Mel frequency cepstrum coefficients(MFCC)which extracts feature mainly from low frequency band is usually used as feature expression.In this paper,by analyzing the distributions of spectral energy of dry/wet cough,it is found that spectral difference of two types of cough exits mainly in middle frequency band and high frequency band.To better reflect the spectral difference of dry cough and wet cough,an improved method of extracting reverse MFCC is proposed.In this method,reverse Mel filter-bank in which filters are allocated in reverse Mel scale is adopted and is improved by placing filters only in the frequency band with high spectral energy.As a result,features are mainly extracted from the frequency band where two types of cough show both high spectral energy and distinguished difference.Detailed process of accessing improved reverse MFCC was introduced and hidden Markov models trained by 60 dry cough and 60 wet cough were used as cough classification model.Classification experiment results for 120 dry cough and 85 wet cough showed that,compared to traditional MFCC,better classification performance was achieved by the proposed method and the total classification accuracy was raised from 89.76%to 93.66%.

  7. Bordetella pertussis, B. parapertussis, vaccines and cycles of whooping cough.

    Bouchez, Valérie; Guiso, Nicole

    2015-10-01

    Whooping cough is a vaccine-preventable disease due to Bordetella pertussis and B. parapertussis. This highly contagious respiratory disease occurs through epidemic cycles every 3-5 years and vaccination did not change this frequency. Models suggest that the cyclic increase of susceptibles is linked to demographic differences and different vaccine coverage. However, differences in surveillance of the disease as well as adaptation of the agents of the disease to their human hosts and to vaccine pressure might also play an important role. These parameters are discussed in this review. © FEMS 2015. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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

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

    1998-01-01

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

  9. Acute effects of short term use of e-cigarettes on airways physiology and respiratory symptoms in smokers with and without airways obstructive diseases and in healthy non smokers

    Anastasios Palamidas; Stamatoula Tsikrika; Paraskevi A. Katsaounou; Sofia Vakali; Sofia-Antiopi Gennimata; George kaltsakas; Christina Gratziou; Nikolaos Koulouris

    2017-01-01

    Introduction Although the use of e-cigarettes is increasing worldwide, their short and long-term effects remain undefined. We aimed to study the acute effect of short-term use of e-cigarettes containing nicotine on lung function and respiratory symptoms in smokers with airways obstructive disease (COPD, asthma), “healthy” smokers, and healthy never smokers. Methods Respiratory symptoms, vital signs, exhaled NO, airways temperature, and airways resistance (Raw), specific airway condu...

  10. Gastro-oesophageal reflux and cough.

    Abdulqawi, Rayid; Houghton, Lesley A; Smith, Jaclyn A

    2013-05-01

    Gastro-oesophageal reflux, either singly or in association with postnasal drip and/or asthma is considered to be a cause of chronic cough. The amount and nature of gastro-oesophageal reflux however is often normal with acid suppression having very little, if any therapeutic effect in these patients. This review examines the challenges posed when exploring the reflux-cough link, and discusses the merits and limitations of the proposed mechanisms of reflux leading to cough.

  11. Evaluating respiratory musculature, quality of life, anxiety, and depression among patients with indeterminate chronic Chagas disease and symptoms of pulmonary hypertension

    Alícia Cristina Suman

    Full Text Available Abstract INTRODUCTION: Chagas disease (CD is progressive and incapacitating, especially when cardiopulmonary function is affected. For example, respiratory muscle weakness can cause dyspnea upon exertion and fatigue, which may be exacerbated when it is associated with pulmonary hypertension (PH. The present study aimed to evaluate respiratory musculature, quality of life, anxiety, and depression among patients with indeterminate chronic CD and symptoms of PH. METHODS: All individuals completed a clinical evaluation, spirometry, a 6-min walking test, respiratory musculature testing using maximum inspiratory pressure (PImax and maximum expiratory pressure (PEmax, the Hospital Anxiety and Depression Scale, and the SF-36 questionnaire. RESULTS: We evaluated 107 patients who were assigned to a control group with only CD (G1, 8 patients, a group with CD and possible PH (G2, 93 patients, and a group with CD and echocardiography evidence of PH (G3, 6 patients. The three groups had similar values for PImax and PEmax. Compared to the G1 and G2 groups, the G3 group covered significantly less distance during the 6-min walking test and had a significantly shorter predicted distance (p < 0.05 vs. the G1 group. All three groups had similar values for their spirometry results, Hospital Anxiety and Depression Scale scores, and SF-36 questionnaire results. CONCLUSIONS: Patients with indeterminate chronic CD and symptoms of PH did not experience significant impairment in the studied variables, with the exception of the 6-min walking test, which suggests a low exercise tolerance.

  12. Cough in Children: Current Approaches to the Treatment

    O.O. Rechkina

    2016-03-01

    Full Text Available Introduction. Cough is one of the most common symptoms in the practice of doctors of various specialties, including pediatricians. Cough treatment should be started with the identification of its cause and correct diagnosis. Most often, cough in children is due to the increased viscosity of bronchial secretions, i.e. violation of sputum transport in the bronchial tree, and insufficient activity of ciliated epithelium. The main objective of the treatment of productive cough is dilution of sputum, bronchial secretion and excretion, thus necessitating the administration of mucolytics. Currently, one of the most famous mucolytics is acetylcysteine, cysteine amino acid product, such as ACC®. However, today the question of ACC® (acetylcysteine application in infants and young children is still debatable. This article presents a study whose objective was to evaluate the therapeutic efficacy and tolerability of ACC® (20 mg/ml solution in the treatment of bronchopulmonary diseases in children aged 2 to 6 years. Materials and methods. The study involved 60 children with acute tracheitis, simple bronchitis, acute obstructive bronchitis, recurrent bronchitis in the acute phase, community-acquired pneumonia, asthma exacerbation, cystic fibrosis. Patients of the main groups (n = 40 received ACC® (20 mg/ml solution at the age-specific dosage 3 times a day in combined treatment. Therapy of patients in the control group (n = 20 was conducted without ACC®. Results. During follow-up, patients who received ACC® had significant positive changes in the nature of cough, sputum viscosity and its amount as opposed to a comparison group of patients. Complete disappearance of cough was achieved on day 5–8 from the beginning of treatment, while in the control group patients, this time was longer. The evaluation of the effectiveness of the study drug showed that very good efficacy was achieved in 75 % of patients and good — in 20 %, and among patients who

  13. Respiratory problems in children with esophageal atresia and tracheoesophageal fistula.

    Porcaro, Federica; Valfré, Laura; Aufiero, Lelia Rotondi; Dall'Oglio, Luigi; De Angelis, Paola; Villani, Alberto; Bagolan, Pietro; Bottero, Sergio; Cutrera, Renato

    2017-09-05

    Children with congenital esophageal atresia (EA) and tracheoesophageal fistula (TEF) have chronic respiratory symptoms including recurrent pneumonia, wheezing and persistent cough. The aim of this study is to describe the clinical findings of a large group of children with EA and TEF surgically corrected and the instrumental investigation to which they have undergone in order to better understand the patient's needs and harmonize the care. A retrospective data collection was performed on 105 children with EA and TEF followed at Department of Pediatric Medicine of Bambino Gesù Children's Hospital (Rome, Italy) between 2010 and 2015. 69/105 (66%) children reported lower respiratory symptoms with a mean age onset of 2.2 ± 2.5 years and only 63/69 (91%) performed specialist assessment at Respiratory Unit. Recurrent pneumonia (33%) and wheezing (31%) were the most reported symptoms. The first respiratory evaluation was performed after surgically correction of gastroesophageal reflux (GER) at mean age of 3.9 ± 4.2 years. Twenty nine patients have undergone to chest CT with contrast enhancement detecting localized atelectasis (41%), residual tracheal diverticulum (34%), bronchiectasis (31%), tracheal vascular compression (21%), tracheomalacia (17%) and esophageal diverticulum (14%). Fifty three patients have undergone to airways endoscopy detecting tracheomalacia (66%), residual tracheal diverticulum (26%), recurrent tracheoesophageal fistula (19%) and vocal cord paralysis (11%). Our study confirms that respiratory symptoms often complicate EA and TEF; their persistence despite medical and surgical treatment of GER means that other etiological hypothesis must be examined and that a complete respiratory diagnostic work up must be considered.

  14. Afferent nerves regulating the cough reflex: Mechanisms and Mediators of Cough in Disease

    Canning, Brendan J.

    2010-01-01

    Bronchopulmonary C-fibers and acid-sensitive, capsaicin-insensitive mechanoreceptors innervating the larynx, trachea and large bronchi regulate the cough reflex. These vagal afferent nerves may interact centrally with sensory input arising from afferent nerves innervating the intrapulmonary airways or even extrapulmonary afferents such as those innervating the nasal mucosa and esophagus to produce chronic cough or enhanced cough responsiveness. The mechanisms of cough initiation in health and in disease are briefly described. PMID:20172253

  15. Outcome of gastro-oesophageal reflux-related respiratory manifestations after laparoscopic fundoplication.

    Adaba, Franklin; Ang, Chin W; Perry, Anthony; Wadley, Martin S; Robertson, Charles S

    2014-01-01

    Patients with refractory respiratory symptoms related to gastro-oesophageal reflux disease (GORD) such as asthma and cough are being referred for laparoscopic fundoplication (LFP), as recommended by the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES). However there are limited data regarding symptomatic response to fundoplication in this group of patients. A 7 year retrospective review was performed to study the efficacy of LFP in the treatment of patients with respiratory manifestations of GORD. Patients were followed up from 4 to 6 weeks (short-term) to 6-12 months (long-term) post-operatively. Of 208 patients who underwent LFP, 73 (35%) patients were eligible for inclusion into the study. 55 (75%) patients had improved respiratory symptoms at short-term follow-up. At long-term follow-up, 7 of these patients had recurrence of respiratory symptoms, while 4 patients had improvement not initially apparent. No significant predictive factor for the success or failure of surgery was identified. 190 (91%) of 208 patients had symptomatic improvement in GORD at short-term follow-up. LFP is effective with the response rates over 75% in the control of respiratory manifestation of GORD, compared to over 91% response rate in the control GOR symptoms alone. More research is needed to identify factors to aid patient selection to improve response rate. Copyright © 2014 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

  16. ANSYS-MATLAB co-simulation of mucus flow distribution and clearance effectiveness of a new simulated cough device.

    Ren, Shuai; Shi, Yan; Cai, Maolin; Zhao, Hongmei; Zhang, Zhaozhi; Zhang, Xiaohua Douglas

    2018-03-05

    Coughing is an irritable reaction that protects the respiratory system from infection and improves mucus clearance. However, for the patients who cannot cough autonomously, an assisted cough device is essential for mucus clearance. Considering the low efficiency of current assisted cough devices, a new simulated cough device based on the pneumatic system is proposed in this paper. Given the uncertainty of airflow rates necessary to clear mucus from airways, the computational fluid dynamics Eulerian wall film model and cough efficiency (CE) were used in this study to simulate the cough process and evaluate cough effectiveness. The Ansys-Matlab co-simulation model was set up and verified through experimental studies using Newtonian fluids. Next, model simulations were performed using non-Newtonian fluids, and peak cough flow (PCF) and PCF duration time were analyzed to determine their influence on mucus clearance. CE growth rate (λ) was calculated to reflect the CE variation trend. From the numerical simulation results, we find that CE rises as PCF increases while the growth rate trends to slow as PCF increases; when PCF changes from 60 to 360 L/min, CE changes from 3.2% to 51.5% which is approximately 16 times the initial value. Meanwhile, keeping a long PCF duration time could greatly improve CE under the same cough expired volume and PCF. The results indicated that increasing the PCF and PCF duration time can improve the efficiency of mucus clearance. This paper provides a new approach and a research direction for control strategy in simulated cough devices for airway mucus clearance. Copyright © 2018 John Wiley & Sons, Ltd.

  17. Prevalence of chronic cough, chronic phlegm & associated factors in Mysore, Karnataka, India.

    Mahesh, P A; Jayaraj, B S; Prabhakar, A K; Chaya, S K; Vijayasimha, R

    2011-07-01

    Chronic cough and chronic phlegm are important indicators of respiratory morbidity, accelerated lung function decline, increased hospitalization and mortality. This study was planned to estimate the prevalence of chronic cough and phlegm in the absence of dyspneoa and wheezing and to study its associated factors in a representative population of Mysore district. A cross-sectional survey was planned in a representative population of Mysore taluk. Eight villages were randomly selected based on the list of villages from census 2001. Trained field workers using the Burden of Obstructive Diseases questionnaire carried out a house-to-house survey. A total of 4333 adult subjects were enrolled in the study with 2333 males and 2000 females. The prevalence of chronic cough in the community was 2.5 per cent and that of chronic phlegm was 1.2 per cent. A significant association was observed between chronic cough and age, gender, occupation and smoking and chronic phlegm with age, gender, occupation, indoor animals and smoking. A multivariate analysis confirmed independent association of age, occupation and smoking for chronic cough and age and smoking for chronic phlegm. On sub-group analysis of males, heavy smokers had higher prevalence of chronic cough and chronic phlegm as compared to light smokers and non smokers. The prevalence of chronic cough was 2.5 per cent and chronic phlegm was 1.2 per cent in the general population in Mysore which is lower than that observed in other studies. Heavy smoking was an important preventable risk factor identified in this study and efforts towards smoking cessation are crucial to achieve good respiratory health in the community.

  18. Headache associated with cough : a review

    Cordenier, Ann; De Hertogh, Willem; De Keyser, Jacques; Versijpt, Jan

    2013-01-01

    Headache only triggered by coughing is a rather uncommon condition. The aim of the present review is to present an overview of the diagnosis, clinical characteristics, pathophysiology and treatment of both primary and symptomatic cough headache and discuss other relevant headache disorders affected

  19. Comparison of clinical characteristics of chronic cough due to non-acid and acid gastroesophageal reflux.

    Xu, Xianghuai; Yang, Zhongmin; Chen, Qiang; Yu, Li; Liang, Siwei; Lü, Hanjing; Qiu, Zhongmin

    2015-04-01

    Little is known about non-acid gastroesophageal reflux-induced chronic cough (GERC). The purpose of the study is to explore the clinical characteristics of non-acid GERC. Clinical symptoms, cough symptom score, capsaicin cough sensitivity, gastroesophageal reflux diagnostic questionnaire (GerdQ) score, findings of multichannel intraluminal impedance-pH monitoring (MII-pH) and response to pharmacological anti-reflux therapy were retrospectively reviewed in 38 patients with non-acid GERC and compared with those of 49 patients with acid GERC. Non-acid GERC had the similar cough character, cough symptom score, and capsaicin cough sensitivity to acid GERC. However, non-acid GERC had less frequent regurgitation (15.8% vs 57.1%, χ(2)  = 13.346, P = 0.000) and heartburn (7.9% vs 32.7%, χ(2)  = 7.686, P  = 0.006), and lower GerdQ score (7.4 ± 1.4 vs 10.6 ± 2.1, t = -6.700, P = 0.003) than acid GERC. Moreover, MII-pH revealed more weakly acidic reflux episodes, gas reflux episodes and a higher symptom association probability (SAP) for non-acid reflux but lower DeMeester score, acidic reflux episodes and SAP for acid reflux in non-acid GERC than in acid GERC. Non-acid GERC usually responded to the standard anti-reflux therapy but with delayed cough resolution or attenuation when compared with acid GERC. Fewer patients with non-acid GERC needed an augmented acid suppressive therapy or treatment with baclofen. There are some differences in the clinical manifestations between non-acid and acid GERC, but MII-pH is essential to diagnose non-acid GERC. © 2014 John Wiley & Sons Ltd.

  20. The impact of harmfulness information on citric acid induced cough and urge-to-cough.

    Janssens, Thomas; Brepoels, Sarah; Dupont, Lieven; Van den Bergh, Omer

    2015-04-01

    The cough reflex is an automatic protective reflex, which can be modulated by conscious effort or other forms of top-down control. In this experiment, we investigated whether information about harmfulness of a cough-inducing substance would augment cough reflex sensitivity and associated urge-to-cough. Healthy participants (N = 39) were randomized to receive information that they were to inhale a harmless substance (natural citric acid), or a potentially harmful substance (a potent agro-chemical acid). Using dosimeter-controlled inhalations, the dose of citric acid eliciting at least three coughs (C3) was determined. Next, participants received 4 blocks of randomized presentations of citric acid at the C3 dose, a sub-threshold dose of citric acid and saline control. C3 was reached for 27/39 participants, and C3 thresholds were not influenced by harmfulness information. During repeated citric acid presentations, framing the cough-inducing substance as a potentially harmful chemical resulted in a greater urge-to-cough compared to information framing it as natural citric acid (p < .01). The experimental manipulation did not influence cough frequencies. Our findings show that harmfulness information influences urge-to-cough, corroborating the role of cortical mechanisms in modulating the urge-to-cough and suggesting that cognitive manipulations may contribute to cough treatment. Copyright © 2015 Elsevier Ltd. All rights reserved.

  1. Honey with Coffee: A new finding in the treatment of Persistent Postinfectious Cough

    Mohammad-Ali Raeessi; Jafar Aslani; Homa Gharaie; Ali-Akbar Karimi Zarchi; Neda Raeessi; Shervin Assari

    2011-01-01

    Introduction: Persistent postinfectious cough (PPC) is a cough that persists longer than 3 weeks or perhaps for many months after a common cold or an upper respiratory tract infection (URTI). PPC has poor response to routine treatment modalities, so it can be a vexing problem for the patient and the physician alike. Our hypothesis was that honey and/or coffee have some beneficial effects in the treatment of PPC. The aim of this study was to evaluate the therapeutic effects of coffee and/or ho...

  2. Effects of bioaerosol exposure on respiratory health in compost workers: a 13-year follow-up study.

    van Kampen, V; Hoffmeyer, F; Deckert, A; Kendzia, B; Casjens, S; Neumann, H D; Buxtrup, M; Willer, E; Felten, C; Schöneich, R; Brüning, T; Raulf, M; Bünger, J

    2016-12-01

    To determine the risk of German compost workers developing chronic respiratory effects from long-term exposure to bioaerosols. Respiratory health was determined in 74 currently exposed compost workers and 37 non-exposed controls after 13 years of follow-up. In addition, 42 former compost workers (drop-outs) who left their work during the follow-up period were also examined. Respiratory symptoms and working conditions were assessed using identical questionnaires as at baseline. In addition, lung function was measured using the same spirometer as in the initial study. Sera from both surveys were tested for specific IgE and IgG antibodies to moulds and the risk of work-related symptoms was evaluated using regression approaches for prospective studies with binary data. In the follow-up period, the number of participants reporting cough significantly increased in compost workers and drop-outs compared to the controls. Working as a compost worker for at least 5 years increased the relative risk for cough (RR 1.28; 95% CI 1.2 to 1.4) and for cough with phlegm (RR 1.32; 95% CI 1.2 to 1.5). Current and former compost workers had slightly lower predicted percentage of forced expiratory volume in 1 s and predicted percentage of forced vital capacity than controls, but decrease in lung function during follow-up was not different among the 3 groups. In addition, no significant changes could be detected in antibody concentrations. Our results suggest that chronic exposure to bioaerosols in composting plants is related to a significantly higher risk for cough with phlegm, indicating chronic bronchitis. However, compost workers showed no higher incidence of deterioration of pulmonary function over the study. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  3. Prostate Cancer: Symptoms, Tests, and Treatment

    ... inability of the adrenal glands to produce enough stress hormones, as well as fatigue, joint pain, nausea, hot flush, diarrhea, vomiting, upper respiratory infection, cough, and headache. Abiraterone acetate tablets are also approved, in combination ...

  4. Effects of acute respiratory virus infection upon tracheal mucous transport

    Gerrard, C.S.; Levandowski, R.A.; Gerrity, T.R.; Yeates, D.B.; Klein, E.

    1985-01-01

    Tracheal mucous velocity was measured in 13 healthy non-smokers using an aerosol labelled with /sup 99m/Tc and a multidetector probe during respiratory virus infections. The movement of boluses of tracheal mucous were either absent or reduced in number in five subjects with myxovirus infection (four influenza and one respiratory syncytial virus) within 48 hr of the onset of symptoms and in four subjects 1 wk later. One subject with influenza still had reduced bolus formation 12-16 wk after infection. Frequent coughing was a feature of those subjects with absent tracheal boluses. In contrast, four subjects with rhinovirus infection had normal tracheal mucous velocity at 48 hr after the onset of symptoms (4.1 +/- 1.3 mm/min). Tracheal mucous velocity was also normal (4.6 +/- 1.1 mm/min) in four subjects in whom no specific viral agent could be defined but had typical symptomatology of respiratory viral infection. During health tracheal mucous velocity was normal (4.8 +/- 1.6 mm/min) in the eleven subjects who had measurements made. Disturbances in tracheal mucous transport during virus infection appear to depend upon the type of virus and are most severe in influenza A and respiratory syncytial virus infection

  5. Efficacy of combined vaccination against Mycoplasma hyopneumoniae and porcine reproductive and respiratory syndrome virus in dually infected pigs.

    Bourry, Olivier; Fablet, Christelle; Simon, Gaëlle; Marois-Créhan, Corinne

    2015-11-18

    Porcine respiratory disease complex (PRDC) is one of the main causes of economic losses for swine producers. This complex is due to a combination of different pathogens and their interactions. Two major pathogens involved in PRDC are Mycoplasma hyopneumoniae (Mhp) and porcine reproductive and respiratory syndrome virus (PRRSV). The objectives of this study were (i) to develop an experimental model of dual Mhp/PRRSV infection in SPF pigs with European strains of Mhp and PRRSV and (ii) to assess and compare the effects of single Mhp, single PRRSV or combined Mhp/PRRSV vaccination against this dual infection. Pigs dually infected with Mhp and PRRSV showed a combination of symptoms characteristic of each pathogen but no significant exacerbation of pathogenicity. Thus, the co-infected pigs displayed coughing and pneumonia typical of Mhp infection in addition to PRRSV-related hyperthermia and decrease in average daily gain (ADG). Hyperthermia was reduced in PRRSV vaccinated animals (single or combined vaccination), whereas ADG was restored in Mhp/PRRSV vaccinated pigs only. Regarding respiratory symptoms and lung lesions, no vaccine decreased coughing. However, all vaccines reduced the pneumonia score but more so in animals receiving the Mhp vaccine, whether single or combined. This vaccine also decreased the Mhp load in the respiratory tract. In conclusion, combined vaccination against both Mhp and PRRSV efficiently pooled the efficacy of each single PRRSV and Mhp vaccination and could be an interesting tool to control PRDC in European swine production. Copyright © 2015 Elsevier B.V. All rights reserved.

  6. Regulating cough through modulation of sensory nerve function in the airways.

    Spina, D; Page, C P

    2013-10-01

    continuous monitoring methodologies for measuring cough will hopefully allow better evaluation of treatments in patients with chronic cough. Nonetheless, cough remains a major unmet clinical need in respiratory medicine where new drugs are urgently required. Copyright © 2013 Elsevier Ltd. All rights reserved.

  7. [A favourable outcome in yellow nail syndrome: role of respiratory physiotherapy].

    Fournier, C; Just, N; Leroy, S; Wallaert, B

    2003-12-01

    The yellow nail syndrome is a rare condition that is easily diagnosed but the nail manifestations are poorly understood. A 51 year old patient presented with a chronic cough. The diagnosis was based on the typical appearance of the nails. The patient had bilateral basal bronchiectasis. Daily physiotherapy with bronchial drainage lead to a progressive improvement in the respiratory symptoms without recourse to antibiotics. Surprisingly the abnormalities of the nails disappeared after 2 years treatment. This observation illustrates the possibility of spontaneous resolution of severe nail abnormalities during the course of the yellow nail syndrome.

  8. The impact of "Ramadan fasting period" on total and differential white blood cells, haematological indices, inflammatory biomarker, respiratory symptoms and pulmonary function tests of healthy and asthmatic patients.

    Askari, V R; Alavinezhad, A; Boskabady, M H

    2016-01-01

    There is no conclusive evidence regarding the effect of fasting on different features in asthmatic patients. In the present study, the effect of Ramadan fasting in asthmatic patients and healthy control was studied. Haematological indices, inflammatory mediators, pulmonary function tests (PFT) and respiratory symptoms were evaluated in 15 asthmatic patients compared to 14 healthy matched control group before and after the one-month fasting period in Ramadan. The change in each parameter from the beginning to the end of Ramadan was calculated and referred to as "variation during Ramadan". The values of MCH, MCHC in both groups and monocyte counts in asthmatic patients, were significantly increased but platelet count was reduced in asthmatic and controls respectively compared to pre-Ramadan fasting period (Pfasting month (Pfasting month in both groups were non-significantly higher compared to pre-fasting values except FVC. Respiratory symptoms in asthmatic patients were non-significantly but wheeze-o was significantly reduced after Ramadan fasting period in asthma group (Pfasting period between two groups, although reduction of hs-CRP in asthmatic group was non-significantly higher than control group. These results show that Ramadan fasting period has no negative impact on asthma and may have some positive effect on asthma severity with regard to reduction of hs-CRP concentration and chest wheeze. Copyright © 2016 SEICAP. Published by Elsevier España, S.L.U. All rights reserved.

  9. COUGH PHYTOTHERAPY IN EARLY CHILDHOOD

    I. V. Davydova

    2012-01-01

    Full Text Available Treatment of acute respiratory infections remains one of the most pressing problems in children. Mucolytic and expectorant therapy aimed at facilitating the expectoration of sputum and improvement of the drainage function of bronchi, is an integral part of this treatment. Expectorant herbal medicine occupies a special niche in the treatment of acute respiratory viral infections. This paper presents literature data on the efficacy and safety of herbal expectorants in children, as well as the results of a comparative analysis of single- and multicomponent herbal medications.  

  10. Indoor air pollution and respiratory health in the elderly.

    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.

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

    Ghada Radwan

    2014-02-01

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

  12. Psychiatric Symptoms in Acute Respiratory Distress Syndrome Survivors: A One-Year National Multi-Center Study

    Huang, Minxuan; Parker, Ann M.; Bienvenu, O. Joseph; Dinglas, Victor D.; Colantuoni, Elizabeth; Hopkins, Ramona O.; Needham, Dale M.

    2015-01-01

    Objective To evaluate prevalence, severity, and co-occurrence of, and risk factors for depression, anxiety, and post-traumatic stress disorder (PTSD) symptoms over the first year after ARDS. Design Prospective longitudinal cohort study. Settings 41 ARDS Network hospitals across the U.S. Patients 698 ARDS survivors. Interventions None. Measurements and Main Results Psychiatric symptoms were evaluated using the Hospital Anxiety and Depression Scale (HADS) and Impact of Event Scale–Revised (IES-R) at 6 and 12 months. Adjusted prevalence ratios for substantial symptoms (binary outcome) and severity scores were calculated using Poisson and linear regression, respectively. During 12 months, a total of 416 of 629 patients (66%) with at least one psychiatric outcome measure had substantial symptoms in at least one domain. There was a high and almost identical prevalence of substantial symptoms (36%, 42%, and 24% for depression, anxiety and PTSD) at 6 and 12 months. The most common pattern of co-occurrence was having symptoms of all 3 psychiatric domains simultaneously. Younger age, female sex, unemployment, alcohol misuse, and greater opioids use in the ICU were significantly associated with psychiatric symptoms, while greater severity of illness and ICU length of stay were not associated. Conclusions Psychiatric symptoms occurred in two-thirds of ARDS survivors with frequent co-occurrence. Sociodemographic characteristics and in-ICU opioids administration, rather than traditional measures of critical illness severity, should be considered in identifying patients at highest risk for psychiatric symptoms during recovery. Given high co-occurrence, ARDS survivors should be simultaneously evaluated for a full spectrum of psychiatric sequelae to maximize recovery. PMID:26807686

  13. Comparison of voice quality in patients with GERD-related dysphonia or chronic cough.

    Domeracka-Kołodziej, Anna; Grabczak, Elżbieta M; Dąbrowska, Marta; Arcimowicz, Magdalena; Lachowska, Magdalena; Osuch-Wójcikiewicz, Ewa; Niemczyk, Kazimierz

    2014-01-01

    The aim was to compare a voice quality in patients with GERD-related dysphonia or chronic cough and to determine whether there is a relationship between the main symptom reported and voice quality. 249 consecutive patients diagnosed with GERD-related chronic cough or dysphonia were involved in this retrospective study and were divided into two main groups of men and women, and furthermore into groups of chronic cough and dysphonia. Laryngeal lesions were evaluated with videolaryngostroboscopy using Reflux Finding Score. Voice quality was assessed using GRBAS scale, sonograms, and multidimensional voice program (MDVP). All subjects were found to have vocal abnormalities both in subjective and objective voice analysis. Perceptual assessment of voice (GRBAS) did not reveal any differences between analyzed groups depending on the reported symptom. In MDVP analysis, the group of women with cough as the main symptom demonstrated significantly less abnormalities in VTI value. In men with cough as their main complaint, significantly less MDVP abnormalities were found in Jita, Jitt, RAP, PPQ, and sPPQ parameters. The comparison of voice perceptual assessment in patients with GERD-related dysphonia or chronic cough revealed no differences between analyzed groups. In objective voice analysis, the latter group presented lower degree of hoarseness in Yanagihara's scale. In objective MDVP analysis, the chronic cough group presented lower degree of abnormalities only in one of the noise related parameters in females and five frequency perturbation parameters in males. Copyright © 2013 Polish Otorhinolaryngology - Head and Neck Surgery Society. Published by Elsevier Urban & Partner Sp. z.o.o. All rights reserved.

  14. Spinal cord injury - Symptoms and causes

    ... breathing, coughing or clearing secretions from your lungs Emergency signs and symptoms Emergency signs and symptoms of ... tackle using the top of your helmet in football. Use a spotter for new moves in gymnastics. ...

  15. Impact of air pollution on respiratory diseases in children with recurrent wheezing or asthma.

    Esposito, Susanna; Galeone, Carlotta; Lelii, Mara; Longhi, Benedetta; Ascolese, Beatrice; Senatore, Laura; Prada, Elisabetta; Montinaro, Valentina; Malerba, Stefano; Patria, Maria Francesca; Principi, Nicola

    2014-08-07

    Air pollution has many negative health effects on the general population, especially children, subjects with underlying chronic disease and the elderly. The aims of this study were to evaluate the effects of traffic-related pollution on the exacerbation of asthma and development of respiratory infections in Italian children suffering from asthma or wheezing compared with healthy subjects and to estimate the association between incremental increases in principal pollutants and the incidence of respiratory symptoms. This prospective study enrolled 777 children aged 2 to 18 years (375 with recurrent wheezing or asthma and 402 healthy subjects). Over 12 months, parents filled out a daily clinical diary to report information about respiratory symptoms, type of medication used and healthcare utilization. Clinical data were combined with the results obtained using an air pollution monitoring system of the five most common pollutants. Among the 329 children with recurrent wheezing or asthma and 364 healthy subjects who completed follow-up, children with recurrent wheezing or asthma reported significantly more days of fever (p=0.005) and cough (ppollution and the development of asthma exacerbations and respiratory infections in children born to atopic parents and in those suffering from recurrent wheezing or asthma. These findings suggest that environmental control may be crucial for respiratory health in children with underlying respiratory disease.

  16. Olodaterol Attenuates Citric Acid-Induced Cough in Naïve and Ovalbumin-Sensitized and Challenged Guinea Pigs

    Wex, Eva; Bouyssou, Thierry

    2015-01-01

    Excessive coughing is a common feature of airway diseases. Different G-protein coupled receptors, including β2-adrenergic receptors (β2-AR), have been implicated in the molecular mechanisms underlying the cough reflex. However, the potential antitussive property of β2-AR agonists in patients with respiratory disease is a matter of ongoing debate. The aim of our study was to test the efficacy of the long-acting β2-AR agonist olodaterol with regard to its antitussive property in a pre-clinical model of citric acid-induced cough in guinea pigs and to compare the results to different clinically relevant β2-AR agonists. In our study β2-AR agonists were intratracheally administered, as dry powder, into the lungs of naïve or ovalbumin-sensitized guinea pigs 15 minutes prior to induction of cough by exposure to citric acid. Cough events were counted over 15 minutes during the citric acid exposure. Olodaterol dose-dependently inhibited the number of cough events in naïve and even more potently and with a greater maximal efficacy in ovalbumin-sensitized guinea pigs (p citric acid-induced cough in naïve and ovalbumin-sensitized guinea pigs. This is in agreement with pre-clinical and clinical studies showing antitussive efficacy of β2-AR agonists. Indacaterol increased the number of coughs in this model, which concurs with clinical data where a transient cough has been observed after indacaterol inhalation. While the antitussive properties of β2-AR agonists can be explained by their ability to lead to the cAMP-induced hyperpolarization of the neuron membrane thereby inhibiting sensory nerve activation and the cough reflex, the mechanism underlying the pro-tussive property of indacaterol is not known. PMID:25781609

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

    Neice Müller Xavier Faria

    2006-10-01

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

  18. A novel reflex cough testing device.

    Fujiwara, Kazunori; Kawamoto, Katsuyuki; Shimizu, Yoko; Fukuhara, Takahiro; Koyama, Satoshi; Kataoka, Hideyuki; Kitano, Hiroya; Takeuchi, Hiromi

    2017-01-18

    The reflex cough test is useful for detecting silent aspiration, a risk factor for aspiration pneumonia. However, assessing the risk of aspiration pneumonia requires measuring not only the cough reflex but also cough strength. Currently, no reflex cough testing device is available that can directly measure reflex cough strength. We therefore developed a new testing device that can easily and simultaneously measure cough strength and the time until the cough reflex, and verified whether screening with this new instrument is feasible for evaluating the risk of aspiration pneumonia. This device consists of a special pipe with a double lumen, a nebulizer, and an electronic spirometer. We used a solution of prescription-grade L-tartaric acid to initiate the cough reflex. The solution was inhaled through a mouthpiece as a microaerosol produced by an ultrasonic nebulizer. The peak cough flow (PCF) of the induced cough was measured with the spirometer. The 70 patients who participated in this study comprised 49 patients without a history of pneumonia (group A), 21 patients with a history of pneumonia (group B), and 10 healthy volunteers (control group). With the novel device, PCF and time until cough reflex could be measured without adverse effects. The PCF values were 118.3 ± 64.0 L/min, 47.7 ± 38.5 L/min, and 254.9 ± 83.8 L/min in group A, group B, and the control group, respectively. The PCF of group B was significantly lower than that of group A and the control group (p reflex was 4.2 ± 5.9 s, 7.0 ± 7.0 s, and 1 s in group A, group B, and the control group, respectively. This duration was significantly longer for groups A and B than for the control group (A: p reflex and the strength of involuntary coughs for assessment of patients at risk of aspiration pneumonia.

  19. Pulmonary symptoms and diagnoses are associated with HIV in the MACS and WIHS cohorts.

    Gingo, Matthew R; Balasubramani, Goundappa K; Rice, Thomas B; Kingsley, Lawrence; Kleerup, Eric C; Detels, Roger; Seaberg, Eric C; Greenblatt, Ruth M; Holman, Susan; Huang, Laurence; Sutton, Sarah H; Bertolet, Marnie; Morris, Alison

    2014-04-30

    Several lung diseases are increasingly recognized as comorbidities with HIV; however, few data exist related to the spectrum of respiratory symptoms, diagnostic testing, and diagnoses in the current HIV era. The objective of the study is to determine the impact of HIV on prevalence and incidence of respiratory disease in the current era of effective antiretroviral treatment. A pulmonary-specific questionnaire was administered yearly for three years to participants in the Multicenter AIDS Cohort Study (MACS) and Women's Interagency HIV Study (WIHS). Adjusted prevalence ratios for respiratory symptoms, testing, or diagnoses and adjusted incidence rate ratios for diagnoses in HIV-infected compared to HIV-uninfected participants were determined. Risk factors for outcomes in HIV-infected individuals were modeled. Baseline pulmonary questionnaires were completed by 907 HIV-infected and 989 HIV-uninfected participants in the MACS cohort and by 1405 HIV-infected and 571 HIV-uninfected participants in the WIHS cohort. In MACS, dyspnea, cough, wheezing, sleep apnea, and incident chronic obstructive pulmonary disease (COPD) were more common in HIV-infected participants. In WIHS, wheezing and sleep apnea were more common in HIV-infected participants. Smoking (MACS and WIHS) and greater body mass index (WIHS) were associated with more respiratory symptoms and diagnoses. While sputum studies, bronchoscopies, and chest computed tomography scans were more likely to be performed in HIV-infected participants, pulmonary function tests were no more common in HIV-infected individuals. Respiratory symptoms in HIV-infected individuals were associated with history of pneumonia, cardiovascular disease, or use of HAART. A diagnosis of asthma or COPD was associated with previous pneumonia. In these two cohorts, HIV is an independent risk factor for several respiratory symptoms and pulmonary diseases including COPD and sleep apnea. Despite a higher prevalence of chronic respiratory symptoms

  20. Whooping Cough: A Brief History to the 19th Century.

    Weston, Robert

    2012-01-01

    This paper examines the history of whooping cough (pertussis) from its first recorded mention in 1190 to the time when its microbial cause was identified. The historical records of the disease are complicated by the variation in the nomenclature employed and through using the same name for disorders with different symptoms. During the early-modern period it was considered to be a disease new to Europe-contagious, dangerous, and potentially epidemic. Believed to be confined to children, its significance was limited until the 18th century when its incidence increased markedly. This essay argues pertussis may have occurred in the late medieval period in individual, though not epidemical, cases.

  1. Cough-variant asthma: a diagnostic dilemma in the occupational setting.

    Lipińska-Ojrzanowska, A; Wiszniewska, M; Walusiak-Skorupa, J

    2015-03-01

    Cough-variant asthma (Corrao's syndrome) is defined as the presence of chronic non-productive cough in patients with bronchial hyperresponsiveness (BHR) and response to bronchodilator therapy. This variant of asthma may present a diagnostic problem in occupational medicine. To describe additional evaluation of cough-variant asthma in a cyanoacrylate-exposed worker in whom standard diagnostic testing was negative. A female beautician was evaluated for suspected occupational allergic rhinitis and asthma. A specific inhalation challenge test (SICT) was performed with cyanoacrylate glues used for applying artificial eyelashes and nails. Spirometry and peak expiratory flow (PEF) measurements were recorded hourly for 24h; methacholine challenge testing was performed and nasal lavage (NL) samples were analysed for eosinophilia. After SICT, the patient developed sneezing, nasal airflow obstruction and cough. Declines in forced expiratory volume in 1 s and PEF were not observed. Eosinophil proportions in NL fluid increased markedly at 4 and 24h after SICT. A significant increase in BHR also occurred 24h after SICT. Clinical symptoms, post-challenge BHR and increased NL eosinophil counts confirmed a positive response to SICT and validated the diagnosis of cough-variant occupational asthma. SICT may be useful in cases where history and clinical data suggest cough-variant asthma and spirometric indices are negative. © The Author 2014. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  2. Implementation of smoke-free legislation in Malaysia: are adolescents protected from respiratory health effects?

    Zulkifli, Aziemah; Abidin, Najihah Zainol; Abidin, Emilia Zainal; Hashim, Zailina; Rahman, Anita Abd; Rasdi, Irniza; Syed Ismail, Sharifah Norkhadijah; Semple, Sean

    2014-01-01

    This study aimed to examine the relationship between respiratory health of Malaysian adolescents with secondhand smoke (SHS) exposure and smoke-free legislation (SFL) implementation. A total of 898 students from 21 schools across comprehensive- and partial-SFL states were recruited. SHS exposures and respiratory symptoms were assessed via questionnaire. Prenatal and postnatal SHS exposure information was obtained from parental-completed questionnaire. The prevalence of respiratory symptoms was: 11.9% ever wheeze, 5.6% current wheeze, 22.3% exercise-induced wheeze, 12.4% nocturnal cough, and 13.1% self-reported asthma. SHS exposure was most frequently reported in restaurants. Hierarchical logistic regression indicates living in a comprehensive-SFL state was not associated with a lower risk of reporting asthma symptoms. SHS exposure in public transport was linked to increased risk for wheeze (Adjusted Odds Ratio (AOR) 16.6; 95%confidence interval (CI), 2.69-101.7) and current wheezing (AOR 24.6; 95%CI, 3.53-171.8). Adolescents continue to be exposed to SHS in a range of public venues in both comprehensive- and partial-SFL states. Respiratory symptoms are common among those reporting SHS exposure on public transportation. Non-compliance with SFL appears to be frequent in many venues across Malaysia and enforcement should be given priority in order to reduce exposure.

  3. Late-onset Radiologic Findings of Respiratory System Following Sulfur Mustard Exposure

    Mahnaz Amini

    2013-06-01

    Full Text Available Background: Sulfur mustard (SM as a chemical warfare agent, increases permeability of bronchial vessels and damages airway epithelium. SM exposure causes debilitating respiratory complications. This study was designed to evaluate clinical respiratory manifestations, and to compare chest X ray (CXR and high resolution computed tomography (HRCT scan of chest in SM exposed patients with respiratory complaints. Methods:All patients with history of SM exposure who visited Imam Reza Specialized Clinic of Respiratory Diseases from September 2001 to March 2011 were included. Patients with other comorbidities which affect respiratory system were excluded. CXR and chest HRCT scan were performed on the same day and were repeated after 5 years. Clinical and radiologic findings were collected and were compared with each other. Results: In total, 62 male patients with mean age of 53 (6.9, 41-65 were studied. Dyspnea (61 cases; 100%, dry cough (40 cases; 66%, hemoptysis (21 cases; 35% and productive cough (20 cases; 33% were the most common respiratory manifestations. Pulmonary infiltration (51; 83%, pleural thickening (25; 40% and emphysema (16; 26% were the most common findings on CXR. According to HRCT scan, pulmonary infiltration (53; 85%, bronchiolitis obliterans (38; 61% and pleural thickening (36; 58% were the most common findings (Table 2. Repeated radiologic assessments after 5 years showed a few additional findings in HRCT scan, while in about one fifth of CXRs, new pathologic findings were found. Conclusion: Patients with SM exposure experience debilitating respiratory disorders in long term. Repeating CXR in patients who present with subjective symptoms may show new findings; however, repeating HRCT scan is probably not necessary.

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

    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

  5. Patient education about cough: effect on the consulting behaviour of general practice patients.

    Rutten, G; Van Eijk, J; Beek, M; Van der Velden, H

    1991-07-01

    The aim of this general practice study was to examine how the consulting behaviour of patients with a cough was affected when the tasks and responsibilities of patients, practice nurses and general practitioners were reorganized. In four 'average' single-handed general practices the effects on the consulting behaviour of patients of a rational practice policy on cough and the provision of systematic patient education on cough were compared with patient behaviour in four matched control practices. Changes of behaviour were measured in 548 patients who consulted for cough at least twice, in two successive autumn-winter periods. Significantly more patients in the experimental practice changed their behaviour to follow the practice guidelines than did patients in the control practices (56% versus 30%, P less than 0.001). The proportion of patients who continued to consult in the approved manner was greater among patients receiving intervention (66% versus 29%, P less than 0.001). This was equally true for patients who had suffered less than four episodes of cough or more than four episodes. The more often the patients received the education, the more effective it was. All patients who consulted the general practitioner for cough during the first autumn-winter period filled in a cough diary during the second period. From this it appeared that the intervention did not result in patients delaying consultation when they had a cough lasting longer than three weeks or one with 'serious' symptoms. It would appear that a rational practice policy and the provision of patient education can stimulate patients to modify their consulting behaviour. This could result in a reduction in the costs of health care.

  6. Help Protect Babies from Whooping Cough

    ... this? Submit What's this? Submit Button Past Emails Help Protect Babies from Whooping Cough Language: English (US) ... Emails Language: English (US) Español (Spanish) File Formats Help: How do I view different file formats (PDF, ...

  7. One Family's Struggles with Pertussis (Whooping Cough)

    Full Text Available ... hiv/aids overview current news labs links & resources hpv overview why vaccinate posters buttons and banners videos ... q & a videos chickenpox (varicella) hepatitis b hib hpv pertussis (whooping cough) pneumococcal rotavirus shingles media room ...

  8. One Family's Struggles with Pertussis (Whooping Cough)

    Full Text Available ... getvaxed about GETVAXED print ads go to GETVAXED.ORG cme Immunizations Pertussis (Whooping Cough) One family's struggles ... free-of-charge. Branded videos contain the "PKIDs.ORG" end slate; unbranded videos are provided for organizations ...

  9. Theobromine inhibits sensory nerve activation and cough.

    Usmani, Omar S; Belvisi, Maria G; Patel, Hema J; Crispino, Natascia; Birrell, Mark A; Korbonits, Márta; Korbonits, Dezso; Barnes, Peter J

    2005-02-01

    Cough is a common and protective reflex, but persistent coughing is debilitating and impairs quality of life. Antitussive treatment using opioids is limited by unacceptable side effects, and there is a great need for more effective remedies. The present study demonstrates that theobromine, a methylxanthine derivative present in cocoa, effectively inhibits citric acid-induced cough in guinea-pigs in vivo. Furthermore, in a randomized, double-blind, placebo-controlled study in man, theobromine suppresses capsaicin-induced cough with no adverse effects. We also demonstrate that theobromine directly inhibits capsaicin-induced sensory nerve depolarization of guinea-pig and human vagus nerve suggestive of an inhibitory effect on afferent nerve activation. These data indicate the actions of theobromine appear to be peripherally mediated. We conclude theobromine is a novel and promising treatment, which may form the basis for a new class of antitussive drugs.

  10. One Family's Struggles with Pertussis (Whooping Cough)

    Full Text Available ... immunizations current news Flu's Gonna Lose hepatitis a & b vaccines im/sq how to do kids infect ... vaccine safety q & a videos chickenpox (varicella) hepatitis b hib hpv pertussis (whooping cough) pneumococcal rotavirus shingles ...

  11. Cough Medicine: Understanding Your OTC Options

    ... CorrectlyPain Relievers: Understanding Your OTC OptionsAntacids and Acid Reducers: OTC Relief for Heartburn and Acid RefluxOTC Cough ... Loss and Diet Plans Nutrients and Nutritional Info Sugar and Sugar Substitutes Exercise and Fitness Exercise Basics ...

  12. One Family's Struggles with Pertussis (Whooping Cough)

    Full Text Available ... freed meet keri russell posters grand article rich media video/audio pneumonia tb overview links & resources families ... hib hpv pertussis (whooping cough) pneumococcal rotavirus shingles media room Flu's Gonna Lose M.O.V.E. ...

  13. One Family's Struggles with Pertussis (Whooping Cough)

    Full Text Available ... GETVAXED print ads go to GETVAXED.ORG cme Immunizations Pertussis (Whooping Cough) One family's struggles with pertussis ... not possible without a visit to your doctor. Immunizations stop disease from spreading. Check with your family ...

  14. Effects of environmental tobacco smoke on the respiratory health of children

    Cinar, N.D.; Dede, C.

    2010-01-01

    Infections of the respiratory tract are the most common acute illness of childhood. Apart from the morbidity (and occasional mortality) attributable to respiratory infections, they also represent risk factors for asthma and possibly other chronic respiratory effects in later life. Children's exposure to harmful substances of tobacco smoke begins at prenatal period, if pregnant woman smokes after the delivery, it continues postnatally to be paced. Children are especially sensitive to the respiratory effects of environmental tobacco smoke (ETS) exposure. ETS exposure is an significant and avoidable risk factor for respiratory diseases among children. ETS is a wide-spread environmental pollutant that has been long linked with respiratory problems. In children of all ages ETS exposure has been found to be associated with increased respiratory symptoms such as wheeze and cough. The role ETS plays in the development of atopy is of great interest, as atopy is closely related to the development of childhood asthma. Exposure to environmental tobacco smoke is preventable. This review discusses primarily on impact of ETS on during the fetal period and infancy and childhood.This paper reviews of several articles between year 1992- 2009 obtained from the internet; Pubmed and Medline. (author)

  15. Effect of Disease Definition on Perceived Burden of Acute Respiratory Infections in Children: A Prospective Cohort Study Based on Symptom Diaries.

    Zoch, Beate; Günther, Annette; Karch, André; Mikolajczyk, Rafael

    2017-10-01

    Acute respiratory infections (ARIs) are among the most frequent childhood diseases in Western countries. Assessment of ARI episodes for research purposes is usually based on parent-administered retrospective questionnaires or prospective symptom diaries. The aim of our analysis was to compare the effect of ARI definitions on the corresponding disease burden in a prospective cohort study using symptom diaries. A literature search was performed to identify definitions of ARI used in research studies. The definitions were applied to a symptom diary dataset from a cohort study of 1-3-year-old children conducted in the winter season 2013/2014. We compared the total number of ARI episodes, the total number of days with ARI and the median and mean duration of ARI episodes resulting from the use of the different definitions. Six ARI definitions were identified in the literature. Depending on ARI definition, the total number of ARI episodes and the total number of days with ARI in our dataset varied by a factor of 1.69 and 1.53, respectively, between the lowest and the highest. The median duration of the episodes ranged from 7 to 10 days. Different definitions led to considerable differences in the number and duration of ARI episodes, making direct comparisons of studies with different methods questionable. We propose the use of a standardized ARI definition in upcoming cohort studies working with diary data. This process could be conducted using a Delphi survey with experts in this study field.

  16. Gender and respiratory findings in workers occupationally exposed to organic aerosols: A meta analysis of 12 cross-sectional studies

    Mustajbegovic Jadranka

    2009-01-01

    Full Text Available Abstract Background Gender related differences in respiratory disease have been documented. The aim of this study was to investigate gender related differences in respiratory findings by occupation. We analyzed data from 12 of our previously published studies. Methods Three thousand and eleven (3011 workers employed in "organic dust" industries (1379 female and 1632 male were studied. A control group of 806 workers not exposed to any kind of dust were also investigated (male = 419, female = 387. Acute and chronic respiratory symptoms and lung function were measured. The weighted average method and the Mantel-Haentszel method were used to calculate the odds ratios of symptoms. Hedge's unbiased estimations were used to measure lung function differences between men and women. Results There were high prevalences of acute and chronic respiratory symptoms in all the "dusty" studied groups compared to controls. Significantly less chronic cough, chronic phlegm as well as chronic bronchitis were found among women than among men after the adjustments for smoking, age and duration of employment. Upper respiratory tract symptoms by contrast were more frequent in women than in men in these groups. Significant gender related lung function differences occurred in the textile industry but not in the food processing industry or among farmers. Conclusion The results of this study suggest that in industries processing organic compounds there are gender differences in respiratory symptoms and lung function in exposed workers. Whether these findings represent true physiologic gender differences, gender specific workplace exposures or other undefined gender variables not defined in this study cannot be determined. These data do not suggest that special limitations for women are warranted for respiratory health reasons in these industries, but the issue of upper respiratory irritation and disease warrants further study.

  17. Gender and respiratory findings in workers occupationally exposed to organic aerosols: a meta analysis of 12 cross-sectional studies.

    Schachter, E Neil; Zuskin, Eugenija; Moshier, Erin L; Godbold, James; Mustajbegovic, Jadranka; Pucarin-Cvetkovic, Jasna; Chiarelli, Angelo

    2009-01-12

    Gender related differences in respiratory disease have been documented. The aim of this study was to investigate gender related differences in respiratory findings by occupation. We analyzed data from 12 of our previously published studies. Three thousand and eleven (3011) workers employed in "organic dust" industries (1379 female and 1632 male) were studied. A control group of 806 workers not exposed to any kind of dust were also investigated (male = 419, female = 387). Acute and chronic respiratory symptoms and lung function were measured. The weighted average method and the Mantel-Haentszel method were used to calculate the odds ratios of symptoms. Hedge's unbiased estimations were used to measure lung function differences between men and women. There were high prevalences of acute and chronic respiratory symptoms in all the "dusty" studied groups compared to controls. Significantly less chronic cough, chronic phlegm as well as chronic bronchitis were found among women than among men after the adjustments for smoking, age and duration of employment. Upper respiratory tract symptoms by contrast were more frequent in women than in men in these groups. Significant gender related lung function differences occurred in the textile industry but not in the food processing industry or among farmers. The results of this study suggest that in industries processing organic compounds there are gender differences in respiratory symptoms and lung function in exposed workers. Whether these findings represent true physiologic gender differences, gender specific workplace exposures or other undefined gender variables not defined in this study cannot be determined. These data do not suggest that special limitations for women are warranted for respiratory health reasons in these industries, but the issue of upper respiratory irritation and disease warrants further study.

  18. A stepwise protocol for the treatment of refractory gastroesophageal reflux-induced chronic cough

    Xu, Xianghuai; Lv, Hanjing; Yu, Li; Chen, Qiang; Liang, Siwei

    2016-01-01

    Background Refractory gastroesophageal reflux-induced chronic cough (GERC) is difficult to manage. The purpose of the study is to evaluate the efficacy of a novel stepwise protocol for treating this condition. Methods A total of 103 consecutive patients with suspected refractory reflux-induced chronic cough failing to a standard anti-reflux therapy were treated with a stepwise therapy. Treatment commences with high-dose omeprazole and, if necessary, is escalated to subsequent sequential treatment with ranitidine and finally baclofen. The primary end-point was overall cough resolution, and the secondary end-point was cough resolution after each treatment step. Results High-dose omeprazole eliminated or improved cough in 28.1% of patients (n=29). Further stepwise of treatment with the addition of ranitide yielded a favorable response in an additional 12.6% (n=13) of patients, and subsequent escalation to baclofen provoked response in another 36.9% (n=38) of patients. Overall, this stepwise protocol was successful in 77.6% (n=80) of patients. The diurnal cough symptom score fell from 3 [1] to 1 [0] (Z=6.316, P=0.000), and the nocturnal cough symptom score decreased from 1 [1] to 0 [1] (Z=–4.511, P=0.000), with a corresponding reduction in the Gastroesophageal Reflux Diagnostic Questionnaire score from 8.6±1.7 to 6.8±0.7 (t=3.612, P=0.000). Conversely, the cough threshold C2 to capsaicin was increased from 0.49 (0.49) µmol/L to 1.95 (2.92) µmol/L (Z=–5.892, P=0.000), and the cough threshold C5 was increased from 1.95 (2.92) µmol/L to 7.8 (5.85) µmol/L (Z=–5.171, P=0.000). Conclusions Sequential stepwise anti-reflux therapy is a useful therapeutic strategy for refractory reflux-induced chronic cough. PMID:26904227

  19. Streptococcal Upper Respiratory Tract Infections and Exacerbations of Tic and Obsessive-Compulsive Symptoms: A Prospective Longitudinal Study

    Leckman, James F.; King, Robert A.; Gilbert, Donald L.; Coffey, Barbara J.; Singer, Harvey S.; Dure, Leon S., IV; Grantz, Heidi; Katsovich, Liliya; Lin, Haiqun; Lombroso, Paul J.; Kawikova, Ivana; Johnson, Dwight R.; Kurlan, Roger M.; Kaplan, Edward L.

    2011-01-01

    Objective: The objective of this blinded, prospective, longitudinal study was to determine whether new group A beta hemolytic streptococcal (GABHS) infections are temporally associated with exacerbations of tic or obsessive-compulsive (OC) symptoms in children who met published criteria for pediatric autoimmune neuropsychiatric disorders…

  20. The prevalence and identity of Chlamydia-specific IgE in children with asthma and other chronic respiratory symptoms

    Patel Katir K

    2012-04-01

    Full Text Available Abstract Background Recent studies have confirmed the presence of viable Chlamydia in the bronchoalveolar lavage (BAL fluid of pediatric patients with airway hyperresponsiveness. While specific IgG and IgM responses to C. pneumoniae are well described, the response and potential contribution of Ag-specific IgE are not known. The current study sought to determine if infection with Chlamydia triggers the production of pathogen-specific IgE in children with chronic respiratory diseases which might contribute to inflammation and pathology. Methods We obtained BAL fluid and serum from pediatric respiratory disease patients who were generally unresponsive to corticosteroid treatment as well as sera from age-matched control patients who saw their doctor for wellness checkups. Chlamydia-specific IgE was isolated from BAL and serum samples and their specificity determined by Western blot techniques. The presence of Chlamydia was confirmed by species-specific PCR and BAL culture assays. Results Chlamydial DNA was detected in the BAL fluid of 134/197 (68% patients. Total IgE increased with age until 15 years old and then decreased. Chlamydia-specific IgE was detected in the serum and/or BAL of 107/197 (54% patients suffering from chronic respiratory disease, but in none of the 35 healthy control sera (p p = 0.0001 tested positive for Chlamydia-specific IgE. Asthmatic patients had significantly higher IgE levels compared to non-asthmatics (p = 0.0001. Patients who were positive for Chlamydia DNA or culture had significantly higher levels of serum IgE compared to negative patients (p = 0.0071 and p = 0.0001 respectively. Only 6 chlamydial antigens induced Chlamydia-specific IgE and patients with C. pneumoniae-specific IgE had significantly greater levels of total IgE compared to C. pneumoniae-specific IgE negative ones (p = 0.0001. Conclusions IgE antibodies play a central role in allergic inflammation; therefore production of Chlamydia

  1. Detection of Bordetella pertussis using a PCR test in infants younger than one year old hospitalized with whooping cough in five Peruvian hospitals.

    Castillo, María Esther; Bada, Carlos; Del Aguila, Olguita; Petrozzi-Helasvuo, Verónica; Casabona-Ore, Verónica; Reyes, Isabel; Del Valle-Mendoza, Juana

    2015-12-01

    To report the incidence, epidemiology, and clinical features of Bordetella pertussis in Peruvian infants under 1 year old. A prospective cross-sectional study was conducted in five hospitals in Peru from January 2010 to July 2012. A total of 392 infants under 1 year old were admitted with a clinical diagnosis of whooping cough and tested for B. pertussis by PCR. The pertussis toxin and IS481 genes were detected in 39.54% (155/392) of the cases. Infants aged less than 3 months were the most affected, with a prevalence of 73.55% (114/155). The most common household contact was the mother, identified in 20% (31/155) of cases. Paroxysm of coughing (89.03%, 138/155), cyanosis (68.39%, 106/155), respiratory distress (67.09%, 104/155), and breastfeeding difficulties (39.35%, 61/155) were the most frequent symptoms reported. An increase in pertussis cases has been reported in recent years in Peru, despite national immunization efforts. Surveillance with PCR for B. pertussis is essential, especially in infants less than 1 year old, in whom a higher rate of disease-related complications and higher mortality have been reported. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  2. Dextromethorphan in Cough Syrup: The Poor Man's Psychosis.

    Martinak, Bridgette; Bolis, Ramy A; Black, Jeffrey Ryne; Fargason, Rachel E; Birur, Badari

    2017-09-15

    Dextromethorphan (3-methoxy-N-methylmorphinan), also known as "DXM" and "the poor man's PCP," is a synthetically produced drug that is available in more than 140 over-the-counter cough and cold preparations. Dextromethorphan (DXM) has overtaken codeine as the most widely used cough suppressant due to its availability, efficacy, and safety profile at directed doses. However, DXM is subject to abuse. When consumed at inappropriately high doses (over 1500 mg/day), DXM can induce a state of psychosis characterized by Phencyclidine (PCP)-like psychological symptoms, including delusions, hallucinations, and paranoia. We report a noteworthy case of severe dextromethorphan use disorder with dextromethorphan-induced psychotic disorder in a 40-year-old Caucasian female, whose symptoms remitted only following treatment with a combination of an antipsychotic and mood stabilizer. While some states have begun to limit the quantity of DXM sold or restrict sales to individuals over 18-years of age, there is currently no federal ban or restriction on DXM. Abuse of DXM, a readily available and typically inexpensive agent that is not detected on a standard urine drug screen, may be an under-recognized cause of substance-induced psychosis. It is imperative that clinicians are aware of the potential psychiatric sequelae of recreational DXM use.

  3. Dextromethorphan in Cough Syrup: The Poor Man’s Psychosis

    Martinak, Bridgette; Bolis, Ramy A.; Black, Jeffrey Ryne; Fargason, Rachel E.; Birur, Badari

    2017-01-01

    Dextromethorphan (3-methoxy-N-methylmorphinan), also known as “DXM” and “the poor man’s PCP,” is a synthetically produced drug that is available in more than 140 over-the-counter cough and cold preparations. Dextromethorphan (DXM) has overtaken codeine as the most widely used cough suppressant due to its availability, efficacy, and safety profile at directed doses. However, DXM is subject to abuse. When consumed at inappropriately high doses (over 1500 mg/day), DXM can induce a state of psychosis characterized by Phencyclidine (PCP)-like psychological symptoms, including delusions, hallucinations, and paranoia. We report a noteworthy case of severe dextromethorphan use disorder with dextromethorphan-induced psychotic disorder in a 40-year-old Caucasian female, whose symptoms remitted only following treatment with a combination of an antipsychotic and mood stabilizer. While some states have begun to limit the quantity of DXM sold or restrict sales to individuals over 18-years of age, there is currently no federal ban or restriction on DXM. Abuse of DXM, a readily available and typically inexpensive agent that is not detected on a standard urine drug screen, may be an under-recognized cause of substance-induced psychosis. It is imperative that clinicians are aware of the potential psychiatric sequelae of recreational DXM use. PMID:28936010

  4. [Respiratory disease risk factors in the 5-14 year-old population in an area of Bogota, 2012-2013].

    Rodríguez-Moreno, Natalia; Martínez-Morales, Viviana; Sarmiento-Suarez, Rodrigo; Medina-Palacios, Katalina; Hernández, Luis J

    2013-01-01

    Establishing the prevalence of respiratory symptoms, asthma and rhinitis, possibly associated with air pollution, in 5- to 14-year-old children in Bosa (a conurbation of Bogota), between 2012 and 2013. A sample was taken of 553 children living in the conurbation. The results indicated that when a child lives with people who smoke there was a 1.5 times risk of coughing at night (compared to living in a non-smoking home) such night-time coughing being different to that produced by respiratory infections such as colds, bronchitis and pneumonia. Children living in homes having fireplaces/open cooking areas located less than 100 m apart had 1.6 times greater probability of presenting symptoms. Children attending schools having greater PM10 exposure and living near buildings being constructed or having roads in a poor state of repair less than 100 meters from their homes were 2.5 times more likely to suffer respiratory disease. Children living in damp rooms were 4 times more likely to have wheezed during the past year. The risk of wheezing became increased by 80 % when a child lived within 100 meters of buildings being constructed or near unpaved roads and attended a school having greater exposure. Government intervention is critical for changing respiratory disease-associated extramural risk factors, such as improvements benefitting children which should be carried out in urban areas.

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

    Helen E Wood

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

  6. [Effect of air pollution on respiratory health in school-aged children in the main urban area of Chongqing, China].

    Fan, Ming-Yue; Tang, Xu; Huang, Wei; Dai, Hua; Liu, Xing-Can; Xia, Yin-Yin; Meng, Pan; Zhang, Rui-Yuan; Guo, Yu-Ming; Cheng, Shu-Qun

    2017-04-01

    To investigate the effect of air pollution on respiratory health in school-aged children in the main urban area of Chongqing, China. The main urban area of Chongqing was divided into polluted area and clean area according to the air pollution data shown on the Environmental Protection Agency Website of Chongqing between 2010 and 2015. A cluster sampling method was used to select 695 third- or fourth-grade children from 2 primary schools in the clean or polluted area as study subjects, with 313 children from the clean area and 382 children from the polluted area. Pulmonary function was examined for all children and a standard American epidemiological questionnaire (ATS-DLD-78-C) was used to investigate the prevalence of respiratory diseases and symptoms. Compared with the clean area, the polluted area had significantly higher concentrations of inhalable particles (PM 10 ), fine particulate matter (PM 2.5 ), and nitric oxide (NO X ) (Ppolluted area had significantly higher risks of cough (OR=1.644), cough during cold (OR=1.596), expectoration during cold (OR=2.196), persistent expectoration (OR=1.802), and wheezing (OR=2.415). The boys and girls in the clean area had significantly higher forced vital capacity and forced expiratory volume in one second than those in the polluted area (PAir pollution in the main urban area of Chongqing is associated with the increased prevalence of respiratory symptoms in school-aged children and has certain effect on children's pulmonary function.

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

    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

  8. Risk factors of respiratory syncytial virus infection among pediatric influenza-like illness and severe acute respiratory infections in Suzhou, China.

    Huang, Yukai; Hua, Jun; Wang, Dan; Chen, Liling; Zhang, Jun; Zhu, Hong; Tian, Jianmei; Zhang, Tao; Zhao, Genming

    2018-03-01

    The characteristics and risk factors of respiratory syncytial virus (RSV) infection among children has not yet been fully understood. To address the characteristics of RSV-associated illness and risk factors of RSV infection among children under 5 years of age in Suzhou, China. From April 2011 to March 2014, we conducted a prospective surveillance among children in Suzhou, China. Nasal or throat swabs were collected from outpatients with influenza-like illness (ILI) and inpatients with severe acute respiratory infections (SARI). RSV was detected by reverse-transcriptase polymerase chain reaction and direct fluorescent antibody assay for children with ILI and SARI, respectively. Multivariable logistic-regression models were constructed to explore risk factors and symptoms of RSV infection. Of 3267 ILI and 1838 SARI children enrolled in the study, 192 (5.9%) and 287 (15.6%) tested positive for RSV, respectively. Among ILI patients, children with RSV infections visited clinics more often (P = 0.005) and had longer duration of fever (P = 0.032) than those without RSV infection. All RSV-positive children had an increased risk of having cough (OR = 2.9), rhinorrhea (OR = 1.6), breathing difficulty (OR = 3.4), wheezing (OR = 3.3), and irritability (OR = 2.7). Children aged respiratory infections (OR = 1.3) were more likely to get infected by RSV. Children with SARI had higher positive rate of RSV than those with ILI. Cough, rhinorrhea, and wheezing were the most common symptoms in RSV infection. Children aged respiratory infections were the potential risk factors for RSV infection. © 2017 Wiley Periodicals, Inc.

  9. Symptom profile as assessed on delirium rating scale-revised-98 of delirium in respiratory intensive care unit: A study from India

    Akhilesh Sharma

    2017-01-01

    Full Text Available Aim: This study aimed to evaluate the phenomenology of delirium in patients admitted in a Respiratory Intensive Care Unit (RICU. Methods: Consecutive patients admitted to RICU were screened for delirium using Richmond Agitation-Sedation Scale (RASS, Confusion Assessment Method for ICU (CAM-ICU assessment tool and those found positive for delirium were evaluated by a psychiatrist to confirm the diagnosis. Those with a diagnosis of delirium as per the psychiatrist were evaluated on Delirium Rating Scale-Revised-98 (DRS-R-98 to study phenomenology. Results: All the 75 patients fulfilled the criteria of “acute onset of symptoms” and “presence of an underlying physical disorder” as per the DRS-R-98. Commonly seen symptoms of delirium included disturbances in attention (100%, thought process abnormality (100%, fluctuation in symptoms (97.33% disturbance in, sleep-wake cycle, language disturbance (94.7%, disorientation (81.33%, and short-term memory impairments (73.33%. No patient had delusions and very few (5.3% reported perceptual disturbances. According to RASS subtyping, hypoactive delirium was the most common subtype (n = 34; 45.33%, followed by hyperactive subtype (n = 28; 37.33% and a few patients had mixed subtype of delirium (n = 13; 17.33%. Factor structure of DRS-R-98 symptoms yielded 3 factors (Factor-1: cognitive factor; Factor-2: motoric factor; Factor-3; thought, language, and fluctuation factor. Conclusion: The phenomenology of delirium in ICU patients is similar to non-ICU patients, but hypoactive delirium is the most common subtype.

  10. Acute effects of short term use of e-cigarettes on airways physiology and respiratory symptoms in smokers with and without airways obstructive diseases and in healthy non smokers

    Anastasios Palamidas

    2017-03-01

    Short term u