Commentary: prevention and cost of asthma--a model for cost effective health care.
Explore the source record for details and available documents.
Allergy and Immunology↗
Biomedical subjects
J R Cohn
Publications and source records attributed to J R Cohn.
Airway reactivity induced reversible voice dysfunction in singers.
As the power source for vocalization, the lower respiratory tract plays a key role in voice production. This is particularly true with sustained singing, where continued high ventilatory demands are present. Changes in pulmonary function that are insignificant with normal speech have been shown to lead to performance impairment. The purpose of this study was to examine and characterize this problem in a large group of singers. Systematic evaluation of a defined population, along with inhalational and singing challenge, was the design. The demographic characteristics, history, pulmonary function, and response to treatment were evaluated in 20 professional or serious amateur singers with voice problems, who did not have causal laryngeal pathology, whose history and evaluation suggested increased airway reactivity, and who responded to anti-asthma therapy. An additional patient was challenged by the exercise of singing in the office, with pulmonary function measurements before and after. This group of serious singers demonstrated vocalization complaints referable to bronchodilator responsive airway obstruction. They responded to treatment for asthma, with improvement in their performance-related difficulties. An additional subject demonstrated a small decline in expiratory flow rates with only 20 minutes of singing in the office. This was readily reversed by an inhaled bronchodilator. Singers who present with complaints of impaired vocalization, such as vocal fatigue, decreased control, and excessive muscular tension, should be evaluated for increased airway reactivity as a possible cause of their complaints.
Adolescent↗
The excretion of trace metals in human sweat.
The concentrations of zinc, copper, iron, nickel, cadmium, lead, manganese, sodium and chloride in the sweat of six males and three females were determined after collections utilizing a total body washdown technique. From our results, sweat appears to be an important excretory pathway for zinc and copper. The mean concentrations of nickel and cadmium in sweat were higher than those reported for urine, that of lead was similar to urine. The loss of manganese in sweat is significant. Levels of zinc and iron were lower in sweat from females, possibly reflecting compensation for menstrual and other losses. Collections were made in six subjects simultaneously utilizing a total body washdown method and collections from one arm in an occlusive arm-bag. The arm-bag collection method gave higher and more variable results and is not recommended as an indicator of loss from the entire skin surface.
Adult↗