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PubMed1999

[The diagnostic and therapeutic value of flexible bronchoscopy in foreign-body aspiration misdiagnosed as other respiratory diseases].

To explore the causes of missed diagnosis of foreign-body aspiration and summarize the experiences on the diagnostic and therapeutic use of flexible bronchoscopy (FB) in these patients. Twelve cases of foreign-body aspiration misdiagnosed as other respiratory diseases, confirmed by FB examination were analyzed. All of these patients had no histories of foreign-body aspiration, and no foreign-body shadows were found on their chest films. But there were atelectasis, hilar enlargement and obstructive pneumonia found on the films. Among the patients in this group, 7 cases were misdiagnosed as lung cancer, 2 cases of pneumonia and asthma each, and 1 case as tuberculosis. The diagnoses of all the 12 cases were confirmed by FB examinations. The foreign-bodies of the 11 cases were successfully grasped and taken out through the FB. This suggests that FB should be of great diagnostic and therapeutic value in patients with foreign-body aspiration misdiagnosed as other respiratory diseases.

Adolescent↗
PubMed1992

[Respiratory disease morbidity in workers in ferrovanadium production].

Links between the occupational factors of iron-vanadium production and respiratory morbidity in workers are revealed in the article. The work conditions of such occupational groups as preparatory workers (preparing and splitting of a furnace charge, slag grinding), roast workers, hydro- and electric metallurgy employees are evaluated by hygienic methods. Structure, relative risk and the standardized risk of respiratory diseases formation were shown in different occupational and age groups.

Adult↗
PubMed1988

Self-reported long-term smoking cessation in patients with respiratory disease: prediction of success and perception of health effects.

Smoking status of 372 patients with respiratory disease, who had been advised to quit smoking by a respiratory specialist, was assessed six months after the advice. A multiple logistic regression model was developed for prediction of successful abstinence. The patients were again followed four to seven years later. Questionnaires were returned by 160 patients (43.0%). Of the remaining patients, 27 (7.3%) had died, 12 (3.2%) refused to participate, 53 (14.2%) had no current address available and 120 (32.3%) did not return questionnaires mailed to them. Among the respondents, 31.9% reported at least one year of abstinence from cigarettes, 63.1% were still smoking and 5.0% had quit smoking for periods of less than one year. While the original logistic model was not very useful for predicting long-term success (69.7% accuracy of classification), a model that included, as predictors, six-month smoking status and reasons for smoking other than addiction, was more useful (78.9% accuracy). At follow-up, successful abstainers reported improvement in their respiratory condition but no differences were found in reported symptoms or emotional well-being when they were compared to those who continued to smoke. Treatment implications of these results are discussed and include offers of alternative treatments if short-term abstinence is not achieved following physician advice.

Attitude to Health↗
PubMed2002

Siberian hamster: a new indoor source of allergic sensitization and respiratory disease.

BACKGROUND: The identification of 'unknown' allergic sensitizations may determine the prognosis and treatment of patients with respiratory airway disease. Currently, the presence in homes of 'exotic' animals as pets is increasing. In this article the Siberian hamster or dwarf hamster (Phodopus sungorus) was identified as a new indoor source of aeroallergens and respiratory disease. METHODS: The subjects were six outpatients who were treated for asthma and rhinitis. Siberian hamster hair extract was prepared with a standard wt/vol method, and patients were skin-prick tested with the extract. Serum-specific immunoglobulin (Ig)E against the Siberian hamster, common hamster (Cricetus cricetus) and golden hamster (Mesocricetus auratus) was determined. IgE-immunoblotting was also performed for all six sera. Specific bronchial challenge was carried out with the Siberian hamster extract. RESULTS: Skin prick tests (SPT) with the Siberian hamster extract, and specific IgE-antibodies against Siberian hamster, were strongly positive in all six patients. Determinations of specific IgE-antibodies against C. cricetus and M. auratus were negative in all patients. IgE-immunoblotting of the sera revealed two IgE-binding fractions (MW 18 and 32 kDa) in five of the six sera. Specific bronchial provocation tests resulted in early asthmatic responses in the two patients who were challenged. CONCLUSIONS: The present study reveals the Siberian hamster to be able to induce both sensitization and disease, and this species of hamster should be taken into consideration as a cause of respiratory disease in exposed subjects. A noteworthy finding was the lack of sensitization in our patients to common hamster allergens (M. auratus and C. cricetus) that are usually tested when hamster allergy is suspected.

Adult↗
PubMed1990

[Clinical diagnosis and laboratory study of acute respiratory diseases of viral origin in children].

The authors analyzed retrospectively a group of 477 children aged two months to 16 years (mean age 6 years and 5 months), hospitalized on account of acute respiratory disease and subjected to virological examination. The aetiology was revealed in 53% of the sick children. In the elucidation of the aetiology participated a number of respiratory viruses, in particular the respiratory syncytial virus. The clinical picture of the disease was very varied. It was confirmed that the clinical picture does not make it possible to express in a considerable proportion of patients suspicion of an actual infectious aetiology. A mixed aetiology of acute respiratory diseases and a varied clinical picture indicate the necessity of a rapid virological and bacteriological examination in hospital practice.

Acute Disease↗
PubMed1998

The association of titers to bovine coronavirus with treatment for bovine respiratory disease and weight gain in feedlot calves.

The association between bovine respiratory disease (BRD) and antibody titers to bovine coronavirus (BCV) was studied in 604 calves (19 different groups in 4 different feedlots from 2 provinces). Almost all calves had antibody titers on arrival in the Alberta feedlot and 82% of the calves had an antibody titer on arrival at the Ontario feedlots; titers in calves in Alberta were almost twice as high as those in calves in Ontario. The incidence of infection, in the first mo after arrival as judged by seroconversion, ranged from 61% to 100%; titer increases were much greater in calves in Ontario feedlots. Titer variables were not significantly related to BRD, except on a within-group basis (group was a confounding variable for BCV-BRD associations). Given control of group effects, calves with an antibody titer on arrival appeared to be protected against BRD for the first 28 d in the feedlot, and the association was reasonably linear over the range of titers. Each titer unit on arrival decreased the risk of BRD by about 0.8x (odds ratio). Titer change was not strongly related to the risk of BRD and the relationship was not linear over the range of titer changes. Titer change was strongly and negatively correlated with titer on arrival, and titer change was not significantly related to BRD in the presence of arrival titers. Arrival titer retained its relationship with BRD in the presence of titer data for other putative pathogens. Each higher unit of titer to BCV on arrival increased the 28-day weight gain (controlling for group, initial weight and the occurrence of BRD) by slightly more than 1 kg. Titer change was associated with decreased weight gain, when initial titer was not in the model. The lack of a linear or multivariable association between BCV titer change and BRD, and weight gain, may indicate that BCV is not a major pathogen; or, its lack of significance may merely be due to its strong correlation with arrival titer. Given the associations found in this study, particularly the interprovincial differences in arrival titers, more and different approaches to studying the possible effects of BCV on BRD are in order.

Animals↗
PubMed1999

The effect of maternally derived immunoglobulin G on the risk of respiratory disease in heifers during the first 3 months of life.

The objectives were to investigate the association between postcolostral serum IgG and the development of calf pneumonia, to elaborate the risk factors for pneumonia, and to compare the risk factors for clinician- and caregiver-diagnosed respiratory disease. In a prospective observational cohort study, 410 heifer calves were clinically examined weekly by a veterinarian during their first 3 months of life. With an initial questionnaire and during these weekly visits, management data were collected. A nested matched case-control design was used to compare risk factors between 105 calves with respiratory disease and their 59 control calves from the same initial population. The IgG levels were determined from blood samples taken within 2 weeks after colostrum intake. The appropriate cutoff point for the postcolostral IgG level to indicate failure of passive antibody transfer when predicting pneumonia appeared to be between 800 and 1300 mg/dl (values < or = the cutoff point indicated failure). Calves with low IgG levels had 2-times higher odds of pneumonia than calves with higher IgG concentrations. Housing mostly in the presence of adult cattle was a risk factor for pneumonia, whereas housing mostly alone in a hutch was protective. Feeding of mastitic colostrum was a risk factor for clinician-diagnosed pneumonia in the analysis of the cohort study but not in the matched case-control design. There was a three-times higher risk of pneumonia if calves were given their dam's colostrum for the first feeding and the dam had clinical mastitis at the time of first milking. Caregiver- and clinician-diagnosed pneumonia had slightly different risk factors which implies that caution should be used when comparing studies based on different definitions of pneumonia. The practical implications of this study are that more attention should be paid to proper housing conditions of the calves in order to reduce incidence of pneumonia.

Animals↗
PubMed1997

Incidence of premature birth and neonatal respiratory disease in infants of HIV-positive mothers. The Pediatric Pulmonary and Cardiovascular Complications of Vertically Transmitted Human Immunodeficiency Virus Infection Study Group.

OBJECTIVE: We sought to determine the prematurity rate in infants of HIV-positive mothers and to characterize the incidence and severity of neonatal respiratory disease in this population. STUDY DESIGN: From 1990 to 1994, 600 live-born infants of HIV-infected mothers were enrolled prenatally (73%) or postnatally (27%) from five U.S. centers. Logistic regression was used to determine the association of HIV status in the infant with prematurity (< or = 37 weeks), low birth weight (< or = 2.5 kg), and very low birth weight (< or = 1.5 kg) rates. The incidence of respiratory distress syndrome (RDS), bronchopulmonary dysplasia, meconium aspiration syndrome, and neonatal pneumonia was compared with anticipated rates for gestational age and birth weight. RESULTS: Very high rates of prematurity (19%), low birth weight (18.3%), and very low birth weight (3.3%) were found in the infants of HIV-positive mothers; and HIV infection in the infant was associated with younger gestational age. The overall incidence of RDS was 3% (17/600), which coincided with the anticipated rate, after adjusting for prematurity and birth weight. Only five infants (all < or = 1.5 kg) had bronchopulmonary dysplasia, and none required assisted ventilation beyond 14 days. Three term infants had mild meconium aspiration syndrome, and there were no cases of documented neonatal pneumonia. CONCLUSION: Infants born to HIV-positive mothers exhibited high prematurity and low birth weight rates, and the odds of prematurity were higher in infants who were infected with HIV. Despite the high incidence of prematurity and perinatal risk of this population, incidence and severity of neonatal respiratory disease were not higher than would be expected from available neonatal data in populations not exposed to HIV.

Adult↗
PubMedDate not supplied

Evaluation of secretory IgA childhood respiratory diseases.

Secretory IgA salivary concentration was studied, in order to investigate its influence as a possible causative role in groups of children affected by different respiratory diseases. Allergic bronchial asthma (n = 37), recurrent pneumonias (n = 11), recurrent upper airway infectious (n = 12) and a control group of healthy children (n = 25) were included. The sIgA mean concentration plus S.D. were: 26.0 +/- 11.5, 15.5 +/- 16.7, 21.2 +/- 15.6, 16.2 +/- 12.7 and 30.8 +/- 10.1, respectively. A statistically significant association between decreased or absent levels of sIgA and disease was found, but no correlation between alterations in sIgA concentrations and any class of serum immunoglobulin levels, or with any other analyzed variables could be established. Among the group of diseases studied, a statistically significant difference (p less than 0.01) was found between infectious asthma and controls, recurrent upper airway infections and controls, and between allergic and infectious asthma. These findings support the conclusion that a decrease or absence of sIgA is an important factor to be considered in infectious asthma, as well as in recurrent upper airway infectious diseases affecting children.

Asthma↗
PubMed1990

[Obesity in respiratory diseases and lipid peroxidation].

The authors compared body weight with indices of peroxidation of lipids in 134 patients with unspecific pulmonary diseases. Conjugated diens and dienketones rose parallelly with increase of the excessive body weight. Correlation ratios are described. Considering unfavourable effects of activation lipid peroxidation, obesity may be evaluated as endogenous metabolic risk factors for diseases of the respiratory organs.

Adolescent↗
PubMed1993

[Biostim in the treatment of recurrent respiratory diseases in children].

The authors treated with Biostim (Roussel Uclaf Co., France) 20 children aged 3 to 15 years with relapsing and chronic diseases of the respiratory system. A favourable clinical effect was observed in 45% and improvement in 40% of the patients. In the investigated immunological indicators the response to treatment Biostim was manifested in the antibody immunity by a reduction of IgE values (P < 0.01) and of IgM (P < 0.05). As to cellular immunity, there was a significant increase of the phagocytic activity (P < 0.05). The tolerance of the preparation was very good.

Adjuvants, Immunologic↗
PubMedDate not supplied

The burden of obesity on everyday life: a role for osteoarticular and respiratory diseases.

The burden of obesity on patients' everyday life is high; obese subjects perceive a poor Health-Related Quality of Life (HRQL) in both physical and mental dimensions. We aimed to identify the areas of everyday life limited by health status and factors mainly responsible for perceived problems. The Nottingham Health Profile questionnaire (NHP) was used in 274 obese subjects seeking treatment at a university-based obesity center. Values were compared with normative Italian data, corrected for age and sex. Anthropometric and clinical data were also recorded, and correlated with health status. All domains of NHP were significantly impaired in obesity, the effect size ranging from 0.14 (Emotional Reactions; p = 0.02) to 0.99 (Physical Mobility; p < 0.0001), and varying in relation to gender, age and obesity class. Female subjects reported a higher-than-expected prevalence of problems in most areas of daily life [from 20% (Paid Employment) to 44% (Jobs around the home), compared with 14-26% in controls]. Males reported a high prevalence of problems in Sex life (31%), Holidays (37%) and Hobbies (49%), compared with 14, 14, and 16% in controls, respectively. Logistic regression analysis identified osteoarticular pain (knee and hip pain) and respiratory diseases as major factors predicting a poor HRQL in its physical dimensions, or perceived problems in everyday life. The relative importance of knee pain was higher than that of hip pain. Osteoarticular and respiratory diseases are major determinants of poor HRQL in obesity. Prevention strategies and treatment of somatic diseases are mandatory for a comprehensive approach to obesity.

Adolescent↗
PubMed2004

Thyrotropin-releasing hormone added to corticosteroids for women at risk of preterm birth for preventing neonatal respiratory disease.

BACKGROUND: Thyrotropin-releasing hormones (TRH) added to prenatal corticosteroids has been suggested as a way to further reduce breathing problems and neonatal lung disease in infants born preterm. OBJECTIVES: To assess the effect of giving prenatal TRH in addition to corticosteroids to women at risk of very preterm birth for the prevention of neonatal respiratory disease. SEARCH STRATEGY: We searched the Cochrane Pregnancy and Childbirth Group trials register (July 2003), the Cochrane Central Register of Controlled Trials (The Cochrane Library, Issue 3, 2003), MEDLINE (1965 to July 2003), EMBASE (1988 to July 2003), Current Contents (1997 to July 2003). SELECTION CRITERIA: Randomised controlled trials in women at sufficient risk of preterm birth to warrant the use of prenatal corticosteroids to promote lung maturity. TRH and corticosteroids were compared with corticosteroids with or without placebo. The main outcomes considered were fetal and infant mortality, infant morbidity, childhood development and maternal morbidity. DATA COLLECTION AND ANALYSIS: All assessments of trial eligibility, quality and data extractions were done by at least two authors independently. MAIN RESULTS: Over 4600 women were recruited into the 13 included trials. Five trials were rated of high quality. Overall, prenatal TRH, in addition to corticosteroids, did not reduce the risk of neonatal respiratory disease or chronic oxygen dependence, and did not improve any of the fetal, neonatal or childhood outcomes assessed by intention to treat analyses.Indeed, the data showed prenatal TRH to have adverse effects for women and their infants. All side-effects monitored were more likely to occur in women receiving TRH. In the infants, prenatal TRH increased the risk of needing ventilation (relative risk (RR) 1.16, 95% confidence interval (CI) 1.03 to 1.29, 3 trials, 1969 infants), having a low Apgar score at five minutes (RR 1.48, 95% CI 1.14 to 1.92, 3 trials, 1969 infants) and, for the two trials providing data, was associated with poorer outcomes at childhood follow up. Sensitivity analyses by trial quality, or subgroups with differing times from entry to birth, or different dose regimens of TRH, did not change these findings. REVIEWERS' CONCLUSIONS: Prenatal thyrotropin-releasing hormones, in addition to corticosteroids, given to women at risk of very preterm birth do not improve infant outcomes and can cause maternal side-effects.

Drug Therapy, Combination↗
PubMedDate not supplied

The surface tension of upper airway secretions in patients with and without respiratory disease.

The alveolar-arterial oxygen partial pressure (PAaO2) difference and surface tension of upper airway secretions (UASST) were simultaneously measured in 33 intubated patients. Patients without respiratory disease had UASST and PAaO2 gradients significantly lower than those with chronic obstructive lung disease. Patients in respiratory failure had UASST and PAaO2 gradients significantly higher than when they were out of failure. Correlation of UASST with PAaO2 was good (r = 0.81). These findings demonstrate that UASST closely correlate with the severity of pulmonary disease and suggest that their measurement may be a simple, clinically applicable method of assessing alveolar surfactant function.

Chronic Disease↗
PubMed2006

Reliability and validity of the Infant and Toddler Quality of Life Questionnaire (ITQOL) in a general population and respiratory disease sample.

OBJECTIVE: To evaluate feasibility, internal consistency, test-retest reliability, and concurrent and discriminative validity of the Infant and Toddler Quality of Life Questionnaire (ITQOL) for parents of pre-school children with 12 scales (103-items) covering physical and psychosocial domains and impact of child health on parents, in comparison with the TNO-AZL Pre-school Children Quality of Life Questionnaire (TAPQOL). METHODS: Parents of children from a random general population sample (2 months-4 years old; n = 500) and of an outpatient clinic sample of children with respiratory disease (5 months-[Formula: see text] years old; n = 217) were mailed ITQOL and TAPQOL questionnaires; a retest was sent after two weeks. RESULTS: Feasibility: The response was >or=80% with few missing and non-unique ITQOL-answers (<2%) in both study populations. Some ITQOL-scales (3-4 scales) showed a ceiling effect (>25% at maximum score). Internal consistency: All Cronbach's alpha >0.70. Test-retest Intraclass Correlation Coefficients (ICCs) were moderate or adequate (>or=0.50; p < 0.01) for 10 ITQOL-scales. VALIDITY: ITQOL-scales, with a few exceptions, correlated better with predefined parallel TAPQOL scales than with non-parallel scales. Five to eight ITQOL-scales discriminated clearly between children with few and with many parent-reported chronic conditions, between children with and without doctor-diagnosed respiratory disease and with a low and a high parent-reported medical consumption (p < 0.05). CONCLUSIONS: This study supported the evidence that the ITQOL is a feasible instrument with adequate psychometric properties. The study provided reference ITQOL scores for gender/age subgroups. We recommend repeated evaluations of the ITQOL in varied populations, especially among very young children, including repeated assessments of test-retest characteristics and evaluations of responsiveness to change. We recommend developing and evaluating a shortened ITQOL version.

Asthma↗
PubMed1985

[Laboratory diagnosis of respiratory diseases of cattle].

The authors describe the procedure of laboratory diagnosis for bovine respiratory diseases: direct diagnosis by isolation and for identification of bacteria or viruses and indirect diagnosis by serological methods. They specify the restraints and limits of this diagnosis and the significance results which are obtained and connected with knowledge of anamnestic information.

Animals↗
PubMed1986

Frequency, sensitivity and specificity of roentgenographic features of slight and moderate asbestos-related respiratory diseases.

The possibility of early detection of asbestos-related respiratory diseases was examined on the basis of four x-ray abnormalities, namely, pulmonary fibrosis, pleural plaque, diffuse pleural thickening and diaphragmatic calcification, in a group of workers exposed to chrysotile asbestos. The frequency of these phenomena was compared to the unexposed control group of similar distribution of number, sex and age. Besides the pleural plaques, which had a high specificity, the combination of minor x-ray abnormalities proved to be most characteristic of exposure to asbestos. The more frequent one of the abnormalities, the less specificity it had to asbestos exposure.

Asbestosis↗
PubMedDate not supplied

Mycoplasma pneumoniae respiratory disease symposium: summation and significance.

The symposium on M. pneumoniae respiratory disease has examined the clinical expression of infection in adults and children, the pathophysiologic disturbances which occur, and the laboratory diagnosis by isolation and serology. That these infections are very common has been well documented; however, a variable incidence over periods of several years tends to minimize importance of the disease for many clinicians. While good laboratory diagnostic methods exist, they provide retrospective insight predominantly and are not useful for early diagnosis or therapeutic decision making. Development of rapid diagnostic methods which are sensitive and specific is an important goal for future research. Success would facilitate our understanding and control of M. pneumoniae disease.

Adolescent↗