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PubMed1988

Respiratory symptoms and pulmonary function as predictors of 10-year mortality from respiratory disease, cardiovascular disease, and all causes in the Whitehall Study.

Relationships between various measures of respiratory impairment and 10-year mortality from chronic respiratory diseases, cardiovascular disease and all causes have been investigated in 17,717 male London civil servants aged 40-64 years. Controlling for age and smoking habits, chronic phlegm production was significantly associated with all-causes and respiratory disease mortality. These associations did not persist after controlling for breathlessness or FEV1 percent predicted. Breathlessness was significantly associated with mortality from respiratory and cardiovascular diseases, and all causes. The associations persisted after controlling for age, smoking habits, employment grade, blood pressure, antihypertensive medication, plasma cholesterol level, diabetes, ECG changes, myocardial ischemia, and FEV1 percent predicted. Anti-hypertensive medication, myocardial ischemia and breathlessness showed the strongest associations with cardiovascular disease mortality. FEV1 less than 65% predicted was significantly associated with mortality from respiratory and cardiovascular diseases, and all causes; for the latter two, the rate ratios were not as high as those for breathlessness.

Adult↗
PubMed1996

Adherence to guidelines for the prevention of HIV-related respiratory diseases.

In this study we characterized the pattern of use of preventive therapies for specific respiratory diseases within a cohort of homosexual men and assessed the impact of targeted feedback on the level of compliance with guidelines for these diseases. All human immunodeficiency virus seronegative (HIV-) (n=169) and acquired immune deficiency syndrome (AIDS)-free human immunodeficiency virus seropositive (HIV+) (n=154) participants in our cohort, who completed four annual visits between October 1989 and December 1993, were identified. Information about the use of purified protein derivative (PPD) (tuberculin) testing, history of pneumococcal vaccinations, influenza vaccinations, use of Pneumocystis carinii pneumonia (PCP) prophylaxis, symptoms and CD4 counts was obtained yearly for each subject. In 1992, participating physicians were provided with feedback regarding the overall levels of compliance with contemporary guidelines for the prevention of respiratory disease. As part of this exercise, the guidelines were distributed and discussed. The percentage of HIV+ patients who underwent PPD testing increased from 43 to 65% during the study (p=0.001). Significantly more HIV+ than HIV- patients underwent PPD testing (p<0.001). A total of 144 (94%) HIV+ men received at least one influenza vaccination compared to 60 (35%) HIV- men (p<0.001). Utilization of influenza vaccination in the HIV+ group significantly increased from 78% in 1992 to 92% in 1993 (p<0.001). A total of 104 (68%) HIV+ men received pneumococcal vaccination compared to 2 (1%) HIV- men (p<0.001). Among HIV+ individuals whose absolute CD4+ count was less than 200 cells x mm(-3), the percentage of men who received primary PCP prophylaxis was 0, 86, 72 and 88 for the years 1990-1993, respectively. Among HIV+ patients whose only eligibility criterion for PCP prophylaxis was a CD4+ percentage <20%, compliance was 55, 30, 37 and 50% for the years 1990-1993, respectively. Among HIV+ subjects, increases in the compliance level were noted for all preventive therapies after targeted feedback was provided during the last quarter of 1992. However, only utilization of influenza vaccine exceeded a 90% compliance in 1993. These data demonstrate that a suboptimal level of compliance with current guidelines for the prevention of respiratory disease among human immunodeficiency virus-infected individuals can be significantly improved using targeted feedback. Although it is likely that similar effects could be achieved in other populations or the community at large, this remains to be demonstrated.

AIDS-Related Opportunistic Infections↗
PubMed1996

SWORD '95: surveillance of work-related and occupational respiratory disease in the UK.

An estimated 2,741 new cases of occupational respiratory diseases were reported by chest and occupational physicians in 1995. Total cases reported by 'core' chest physicians and occupational physicians have risen but cases reported by 'sample' physicians have fallen by 32%, reducing the estimated total overall by approximately 16% from 1994. Steps are being taken to reverse this downward trend. Occupational asthma remains the single most frequently reported disease of which more than two thirds of cases were attributed to sensitization. Non-malignant pleural disease was the next most frequently reported, with pleural plaques predominating in 71% of cases. In a study of a selected sample of 158 cases of non-malignant pleural disease, 81 (51%) were seen for medico-legal reasons; of the remainder 13% had signs or symptoms ascribed to the disease.

Adult↗
PubMed2004

Genetic abnormalities in plasma DNA of patients with lung cancer and other respiratory diseases.

The detection of tumour-associated genetic alterations in plasma DNA has been proposed as a simple method for the early diagnosis of lung cancer and for identifying individuals at high risk of lung cancer who might be included in screening or chemoprevention programmes. To evaluate the practicality of this approach, we screened a panel of 16 plasma DNA markers in a lung cancer population to identify those with the highest genetic alteration rate. These were then used to study plasma DNA in 206 hospital outpatients with lung cancer and other respiratory diseases. Plasma and lymphocyte DNA were isolated from blood samples collected from hospital outpatients. Polymerase chain reaction was carried out with 16 microsatellite markers covering chromosomal regions 3p, 8p, 9p, 13q and 17p, using DNA from 32 lung cancer patients. The 3 markers most commonly affected were selected for use in a larger study of 86 lung cancer patients and 120 patients with other respiratory diseases. In the pilot study, 3 primer pairs (D3S1300, D3S1560, D8S201) together detected genetic alterations in plasma DNA in 60% of lung cancer patients. In the larger study, significantly higher genetic alteration rates were observed in lung cancer patients than in patients with other respiratory diseases for the two markers D3S1560 and D8S201. The overall genetic alteration rate was 69% in the lung cancer patients and 42% in the patients with other respiratory diseases (p < 0.001). Analysis of plasma and lymphocyte DNA to detect genetic alterations typical of lung cancer is possible in large studies. The genetic alteration rate we found in lung cancer patients was comparable with other studies. Although the genetic alteration rate was significantly higher in the lung cancer than the respiratory disease patients, it did not have good positive predictive value in this population. Longitudinal studies are required to determine whether genetic changes in plasma DNA of non-cancer patients indicate a high risk of later lung cancer.

Adult↗
PubMed2002

Particulate suspended matters and cases of respiratory disease in Rio de Janeiro city (Brazil).

This paper investigates the existence of a possible relationship between suspended particulate matters levels and cases of respiratory diseases from a random and systematic sample of medical and air pollution records in the metropolitan area of Rio de Janeiro. Records of emergency cases of the year 1991 (months of January, June and July) were collected at Miguel Couto Hospitals and suspended particulate matter (1980-1995) at FEEMA (Rio de Janeiro Environmental Agency). The results revealed that the diseases of the respiratory system of those patients who seek the hospital's emergency care are more frequent during the wintertime. Their number increases markedly during winter months of June and July when compared with the summer's (January) number of cases. The analysis of the historical series (1980-1995) of atmospheric pollution measured at Bonsucesso monitoring station showed that the monthly figures (measured by the number of times that the value exceed the national standard, maximum daily concentration of 240 micro g (-3), are higher in wintertime (June, July and August). During this same period the level of pollution by atmospheric particulate matter in Rio de Janeiro metropolitan area measured by the annual geometric averages showed results well above the national standard (80 micro g(-3). This unfavorable situation, together with the fast growing number of new cars circulating in the city and the absence of a clear air pollution control and management plan, may contribute to an increase of the incidence and seriousness of respiratory diseases during subsequent winter months.

Adolescent↗
PubMed1982

Respiratory disease in a New Mexico population sample of Hispanic and non-Hispanic whites.

To characterize the epidemiologic features of respiratory diseases among Hispanics, we conducted a prevalence survey in Bernalillo County, New Mexico. The ATS-DLD-78 respiratory symptoms questionnaire was completed by 633 Hispanics and 1,038 Anglos (non-Hispanic whites) with an overall response rate of 72%. The prevalence of major respiratory diseases differed between the groups. Physician-confirmed chronic bronchitis or emphysema, and asthma were reported less often by Hispanics. Although patterns of cigarette usage (current, previous, never) were similar, current and cumulative cigarette consumption was significantly lower in Hispanics. Most differences in symptom frequency and the lower Hispanic prevalence of chronic bronchitis or emphysema were attributable to lower cigarette consumption by Hispanics. However, the prevalence of asthma remained significantly lower among Hispanics after controlling for cigarette smoking. These results documented differences in the prevalence of respiratory disease between the Hispanics and Anglos, which were partially explained by the distributions of known risk factors.

Adult↗
PubMed2006

The effect of obesity on chronic respiratory diseases: pathophysiology and therapeutic strategies.

Sedentary lifestyles and increased pollution brought about by industrialization pose major challenges to the prevention of both obesity and chronic respiratory diseases such as chronic obstructive pulmonary disease (COPD), asthma, obstructive sleep apnea and obesity hypoventilation syndrome. Obesity has emerged as an important risk factor for these respiratory diseases, and in many instances weight loss is associated with important symptomatic improvement. Moreover, obesity may influence the development and presentation of these diseases. In this article, we review the current understanding of the influence of obesity on chronic respiratory diseases and the clinical management of obesity concurrent with asthma, COPD, obstructive sleep apnea or obesity hypoventilation syndrome.

Asthma↗
PubMed1976

Respiratory disease mortality among uranium miners.

A mortality analysis of a group of white and Indian uranium miners was done by a life-table method. A significant excess of respiratory cancer among both whites and Indians was found. Nonmalignant respiratory disease deaths among the whites are approaching cancer in importance as a cause of death, probably as a result of diffuse parenchymal radiation damage. Exposure-response curves for nonsmokers are linear for both respiratory cancer and "other respiratory disease." Cigaret smoking elevates and distorts that curve. Light cigaret smokers appear to be most vulnerable to lung parenchymal damage. The predominant histologic cancer among nonsmokers is small-cell undifferntiated, just as it is among cigaret smokers.

Adult↗
PubMed1999

Beta-chemokines are produced in lungs of mice with mycoplasma respiratory disease.

The recruitment of mononuclear cells in lungs is a key event in the pathogenesis of mycoplasma respiratory disease, but the cascade of events responsible is unknown. Studies were conducted to determine whether beta-chemokines, which are chemotactic for lymphocytes and macrophages, are produced in murine mycoplasma respiratory disease. Our results show that mRNA expression of the macrophage chemoattractant factor (MCP-1) and macrophage inflammatory peptides (MIP-1alpha and MIP-1beta), but not RANTES, increases in Mycoplasma pulmonis-infected mice. Also, MCP-1 concentrations were much higher in lung extracts from mycoplasma-infected mice than in uninfected mice. As beta-chemokines are chemotactic for lymphocytes and macrophages, these results suggest that MCP-1, MIP-1alpha, and/or MIP-1beta, but not RANTES, contribute to mononuclear cell infiltration associated with murine mycoplasma respiratory disease. Thus, the activation of cells to produce beta-chemokines is associated with mycoplasma infection, and the beta-chemokines, along with other factors and cytokines, are most likely involved in the cascade of events leading to mycoplasma inflammatory disease.

Animals↗
PubMed1985

Skin test and RAST responses to wheat and common allergens and respiratory disease in bakers.

Interrelationships between skin and humoral tests for immediate hypersensitivity to wheat and indicators of respiratory disease were examined in 176 male bakers. Skin tests were assessed by measuring the diameter of the weal resulting from prick innoculation of allergen extract and circulating allergen-specific IgE by radioallergosorbent test (RAST). Fifteen per cent of subjects showed positive skin-prick test responses to wheat extracts. These subjects demonstrated an increased prevalence of respiratory symptoms and of measurable bronchial responsiveness to methacholine. Thirty per cent of subjects had positive skin test responses to common allergens but negative responses to whole wheat. Compared to subjects with no positive skin test responses they had an increased prevalence of bronchial responsiveness to methacholine but a similar prevalence of respiratory symptoms. There was a significant association between skin test responses to whole wheat and skin test responses to common allergens suggesting that bakers with pre-existing sensitivity to common allergens are at increased risk of developing wheat flour sensitization. There was no significant difference between skin-prick test and RAST responses to wheat, water-soluble wheat protein and common allergens. Both tests showed similar relationships with indices of respiratory disease. The associations between skin test and RAST responses to wheat extracts and indices of respiratory disease was stronger for the water-soluble wheat proteins than for other wheat grain extracts. These results suggest that immediate hypersensitivity to wheat flour is important in the development of non-specific bronchial hyperreactivity in bakers and that the water-soluble fractions of wheat flour are the most important allergenic components.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1976

[Interrelations between otorhinolaryngologic and chronic nonspecific respiratory diseases (author's transl)].

1000 patients, suffering from chronic nonspecific respiratory diseases, were investigated for otorhinolaryngologic diseases. The frequency of pathologic findings such as nose deformities, sinusitis, rhinitis, pharyngitis, tonsillitis, respiratory hypersensitivity and their treatment results are evaluated aiming to find out common causative factors in the pathogenesis of these upper and lower airway diseases. A careful diagnosis and subsequent treatment of otorhinolaryngologic diseases is required to improve the therapeutic results of the basic respiratory disease.

Asthma↗
PubMedDate not supplied

Home care of the infant with gastroesophageal reflux and respiratory disease.

An increasing number of infant's with gastroesophageal reflux (GER) and respiratory disease and are being cared for at home. These infants have a chronic disease requiring long-term medical care. However, once the infant's condition stabilizes, home care is preferable to prolonged hospitalization. Nursing care of the infant with GER and respiratory disease is a challenging process that is complicated by the severity of GER and the degree of respiratory compromise. An understanding of disease process, family process, and skills of assessment are essential in planning care for these infants and their families.

Female↗
PubMed2001

An economic model to calculate farm-specific losses due to bovine respiratory disease in dairy heifers.

This paper describes a personal-computer-based model estimating the economic losses associated with clinical bovine respiratory disease in replacement heifers raised on individual dairy farms. The model is based on the partial-budgeting technique, and calculates the losses for two types of the disease separately: calf pneumonia and a seasonal outbreak. Model input includes farm-specific data such as the incidence of bovine respiratory disease, prices, and effects of the disease on the heifers' productivity. The input database was linked directly with the economic model. For all input parameters, default values used are available to the user and can be modified easily. Losses considered by the model include treatment expenditures and costs associated with increased mortality, increased premature culling, reduced growth, reduced fertility and reduced milk production in first lactation. Uncertainty is taken into account for parameters related to disease incidence, mortality and culling.Basic calculations for a typical Dutch dairy farm with 60% of the heifers (<3 months) affected, indicated total annual losses due to pneumonia average 31.2 per heifer present on the farm (range 18.4-57.1). The estimated losses for one seasonal outbreak with heifers up to 15-months old affected were 27.0 per heifer present (range 17.2-43.1). For both BRD types, the model's outcome was most sensitive to the number of heifers affected. Most of the parameters that had a major impact on the total losses were related to treatment or to the effects on the heifers' productivity. The model is user-friendly and flexible, and can be used as an interactive tool by farmers and veterinarians in the (economic) decision-making process regarding on-farm prevention and control of bovine respiratory disease.

Animals↗
PubMedDate not supplied

[Radioimmunologic tests in children with pruritus and with a combination of pruritus and allergic respiratory disease].

Radioimmunological tests were carried out in 180 children with pruritus and 167 children with pruritus and allergic respiratory diseases. Difference between these groups was statistically insignificant in case of food allergy. Results of RAST were more often positive in case of respiratory allergy in the patients with pruritus and coexisting allergic respiratory diseases than in patients with skin involvement only. Reaction was more intense and allergy polyvalence measured with RAST was higher. All differences were statistically significant (p less than 0.001 or 0.01). Mean IgE levels was higher in children of all age groups in case of pruritus coexisting with allergic respiratory diseases.

Adolescent↗
PubMed1990

A group level analysis of the associations between antibodies to seven putative pathogens and respiratory disease and weight gain in Ontario feedlot calves.

The associations, at the group level, between serological titer to Pasteurella haemolytica surface antigens (Ph), Pasteurella haemolytica cytotoxin (Ph-cytox), infectious bovine rhinotracheitis virus (IBRV), bovine virus diarrhea virus (BVDV), parainfluenza-3 virus (PIV3), respiratory syncytial virus (RSV), Mycoplasma dispar (Md), M. bovis (Mb), and respiratory disease treatment rates, relapse rates, and 28 day weight gains were investigated in 14 groups of calves entering two feedlots during years 1983-1985, in Ontario. Based on least squares regression analyses, seroconversion rates to Mb and BVDV were predictive of increased respiratory disease rates, and seroconversion rates to Ph, Ph-cytox, Md and PIV3 were predictive of decreased weight gains. The R2 for predicting weight gains was much higher than for morbidity rates (0.75 vs 0.47 respectively). Titer data were not predictive of relapse rates. Group level analyses were performed because calves are managed as groups (e.g. pens) in commercial feedlots. Only BVDV seroconversion rates were related to increased risk of respiratory disease at both the individual and group levels of organization. Mycoplasma may be important factors in causing respiratory disease, and their relationship to potentiating the effects of other respiratory pathogens needs further investigation.

Animals↗
PubMed2001

[Proposal for a new method for evaluation of physical exercise capacity in patients with chronic respiratory disease].

We developed a new method of evaluating the tolerance for physical exercise in patients with chronic respiratory disease. Using a newly developed portable pulse oxymeter, with which we could measure kinetic energy (physical activity), calculated from the vertical acceleration involved in physical movements in the patient's daily life, we considered the correlation between the characteristics of the distribution of oxygen saturation (SpO2) and the degree of physical activity. The characteristics of SpO2 distribution in normal healthy subjects are uniform at all degrees of physical activity. In patients with chronic respiratory disease who complained of dyspnea on exertion, these characteristics became more uneven as physical activity increased. By comparing the characteristics of SpO2 distributions at rest with those at certain degrees of physical activity, we could quantitatively evaluate the exercise tolerance of patients with chronic respiratory disease, while monitoring their physical activity and SpO2 in daily life, without burdening the patients with stress such as would be imposed by the treadmill test. This new method is applicable for determining the indications for home oxygen therapy. Its application in home health care could offer a useful evaluation of a patient's activities of daily living and also early discovery of aggravation of chronic respiratory failure.

Adult↗