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PubMed2005

[Epidemiologic analysis of COPD in Guangdong province].

OBJECTIVE: To survey the prevalence of chronic obstructive pulmonary disease (COPD) in urban and rural areas in Guangdong Province and relevant risk factors. METHODS: Using the same protocol including Burden of Obstructive Lung Disease (BOLD) questionnaire, a questionnaire survey was conducted among 3449 respondents, 1370 males and 1916 females, aged over 40 with an average age of 56.8, by random disproportional cluster sampling in Liwang District of Guangzhou City and Yunyan Town, Lechang City, northern Guangdong Province. Spirometry was performed in all subjects. Lung function indices were regarded as gold criteria of diagnosis of COPD. RESULTS: There were 3286 cases with full data and good quality spirometry test, 1370 males and 1916 females, aged 56.8. The total prevalence of COPD was 9.4%. The prevalence of COPD in the males was 15.9%, significantly higher than that in the females (4.8%, P < 0.01). The prevalence in the rural area was 12.0%, significantly higher than that in the urban area (7.4%, chi(2) = 20.3, P < 0.01). 67.7% of the patients with COPD presented symptoms such as cough, expectoration and/or dyspnoea. 58.7% of the COPD patients (78.9% of the male patients and 10.9% of the female patients) smoked. The odd ratio (OR) for COPD in the smokers was 2.59 (95% CI 1.87 - 3.59). Only 15.1% of the smokers (17.9% of the male smokers and 4.1% of the female smokers) developed COPD. No significant relationship was found between pack years of cigarette smoking and COPD prevalence. The risk of COPD was increased when biomass fuels were used in house cooking (OR = 1.54 95% CI 1.08 - 2.20). Furthermore, the combination of biomass fuels and cigarette smoking further increased the risk with the OR of 4.41 (95% CI 3.22 - 6.04), indicating a synergetic impact of smoking and biomass burning on the prevalence of COPD. The Prevalence of doctor-diagnosed COPD based on the clinical manifestation was significant lower than the actual prevalence (only 31.0%). CONCLUSIONS: COPD is a very common disease in Guangdong. The prevalence of COPD is higher in the rural area than in the urban area, which may be attributed to the synergic effect of smoking and biomass burning. Lung function test is of great importance in COPD diagnosis, especially in the earlier stage of COPD and those asymptomatic COPD patients.

Adult↗
PubMed1992

[Dentobronchial syndrome. Can persistent productive cough be caused by parodontitis? A questionnaire study].

In order to investigate the statistical relationship between periodontal disease, symptomless sinuitis and chronic cough an epidemiological survey was performed by questionnaire among 186 patients (age 30-60) suffering from serious periodontal disease. 58% responded. Persistent cough with expectoration was reported only by patients suffering from periodontal disease in the upper molars. The relative risk was significant (p less than 0.01). The prevalence in this group was 28% compared to a 12% prevalence of chronic bronchitis in the normal population. Ten of the patients with persistent cough reported amelioration of symptoms shortly after the dental treatment. This includes eight smokers who continued smoking. The dentists confirmed that the patients in question had very serious periodontal disease. Further investigations including clinical control and X-ray of the teeth and sinuses are recommended.

Adult↗
PubMed2005

[Evaluation on clinical efficacy of treatment of children pneumonia by combined internal-external therapy of TCM].

OBJECTIVE: To evaluate the clinical efficacy of combined internal-external therapy of TCM on children pneumonia. Adopting multi-center, randomized, controlled, double blinded principle, children with pneumonia were divided into 2 groups. Besides the basic treatment of western medicine, to the 406 children in the treated group internal administering of Chinese recipe prescribed according to syndrome differentiation and external applying of Fuxiong plaster were given additionally, while to the 411 children in the control group simulative placeboes were given for instead. The clinical efficacy of treatment on disease and syndrome, improvement of TCM syndrome and physical signs of lung between the two groups were compared after treatment. RESULTS: The cured-markedly effective rate of treatment on disease and syndrome was 97.3%, 95.1% in the treated group and 89.8%, 86.6% in the control group, respectively, the differences of the two indexes between the two groups were significant (P < 0.05). The improvements on physical signs of lung, symptoms as cough, dyspnea and sputum expectorating in the treated group were significantly better than those in the control group (P < 0.05). CONCLUSION: It was showed that the combined internal-external TCM treatment, which could significantly enhance the clinical efficacy, is an effective therapy for children pneumonia.

Administration, Cutaneous↗
PubMed2005

[Effect of intrapulmonary percussive ventilation in a severely disabled patient with persistent pulmonary consolidation].

An intrapulmonary percussive ventilator (IPV) improves airway clearance and lung function, and is useful for wide variety of respiratory disorders, such as cystic fibrosis, chronic obstructive pulmonary disease, aspiration pneumonia, and neuromuscular diseases. However, there are few reports on IPV use in patients with severe neurological impairment, scoliosis and thoracic deformity. They have poor mobility of the rib cage and difficulty in sputum expectoration. The use of IPV significantly improved persistent consolidation shown by chest computed tomography (CT) in one of such patients. The patient was a 33-year-old woman with severe spastic quadriplegia and tracheostomy and she was dependent on mechanical ventilation because of chronic restrictive respiratory failure. After fever and mild hypoxemia for one day, chest CT revealed consolidation of the left lower lobe. An IPV-I ventilator was used for 15 min once a week, with a stroke frequency of 250-300 cycles/min and pressure of 22 PSI. Mechanical ventilation was withheld during the IPV therapy. Chest physiotherapy was also done. According to the worsening of the consolidation on chest CT, the frequency of IPV was changed to once a day at day 23 and then to twice a day. Chest CT at day 44 showed further improvement. In patients with severe motor and intellectual disabilities, it is sometimes difficult to control progressive deterioration of pulmonary function and persistent atelectasis even with tracheostomy, mechanical ventilation, and conventional physiotherapy. Our results indicate that IPV may improve respiratory functio and the quality of life in such patients.

Adult↗
PubMed2005

[Two-stage administration sedation method for gastroscopy in hypoxia predisposed patients].

OBJECTIVE: To explore the safety and the efficacy of two-stage administration sedation method (with propofol plus midazolam) in the analgesia gastroscopy for hypoxia predisposed patients. METHODS: Sixty-four hypoxia predisposed patients (with snore or expectoration) were divided into two groups and received sedation respectively with two-stage administration method and routine continuum administration method before gastroscopy. We analyzed the alteration of SBP, DBP, SpO2, sedation level, the degree of pharyngeal malaise, recovery time, dose of propofol,the lethe degree of upset, and procedure of gastroscopy to evaluate the safety and the efficacy of the two methods in the analgesia gastroscopy for hypoxia predisposed patients. RESULTS: Compared with routine continuum administration sedation method, two-stage administration sedation method had little influence on SpO2, so it reduced the accident of respiratory arrest (P < 0.01). The gastroscopy could be achieved at the lower sedation level with two stage administration method (P <0.01), so that the recovery time was shortened (P < 0.01). The degree of pharyngeal malaise in the patients with two-stage administration sedation method was higher than that of patients with routine continuum administrationsedation method (P < 0.01), and the dose of propofol used for sedation decreased (P < 0.01). While the lethe degree of gastroscopy upset and alteration of SBP, DBP were rated similarly in both groups (P > 0.05), and the lethe degree of gastroscopy procedure in two-stage administration method group was significantly lower than that of routine continuum adminis- tration method group (P <0.01). CONCLUSION: The two-stage administration sedation method is a new effective and safe sedation method for gastroscopy in the hypoxia predisposed patients.

Adult↗
PubMed2005

[Skeletal tuberculosis--diagnostic challenges].

BACKGROUND: Skeletal tuberculosis is rare in Norway. The diagnosis could be difficult. MATERIAL: A Somalian mother and three daughters and a Somalian girl in the neighborhood developed skeletal tuberculosis 4-12 months after arrival in Norway. RESULTS AND INTERPRETATION: All had pain as their main complaint. Skeletal scintigraphy and MRI were decisive for demonstration of the infectious locus. Three patients had spondylitis, two of them with serious abscesses. Other localisations were the frontal bone, the humerus shaft, the femoral shaft, and the calcaneus. Despite no signs or symptoms of lung tuberculosis, culture of expectorate or bronchial lavage fluid yielded growth of Mycobacterium tuberculosis in four patients. This demonstrates the importance of bronchial material also in extrapulmonary tuberculosis.

Adolescent↗
PubMedDate not supplied

[Induced sputum--means for detecting bronchial inflammation in children with atopic bronchial asthma and treatment monitoring].

Induced sputum is a very recent technique for exploration of bronchial inflammation in asthma. Since 1992, it has significantly improved as a method and as clinical and fundamental research tool for asthma. It is currently recognized that this method is well tolerated and can be used in all asthma patients, except those with FEV1 less than 11. Eosinophilic activation in asthma can be very well highlighted by cellular and biochemical analysis of expectoration. Thus, biologic arguments can be added to clinical signs in asthma exacerbations. Clinical evolution under corticosteroids can be biologically proved by this technique. Sputum analysis is useful also for differential diagnosis, sometimes difficult, between asthma and COPD.

Administration, Inhalation↗
PubMed2005

[A case of pulmonary Mycobacterium scrofulaceum infection presented as pleurisy].

A 68-year-old man was referred to our hospital for further examination of pleurisy. Before this admissions, he was diagnosed as having tuberculous pleurisy initially and later as having pleurisy due to SLE in another hospital. He was administered anti-tuberculous medicine including INH, RFP and EB empirically, and later prednisolone and azathioprine. Despite of these medications, there was no improvement. After admission to our hospital, positive results for acid fast bacilli were obtained from both sputum and pleural fluid, and they were identified as Mycobacterium scrofulaceum. He was treated successfully with the combination of INH, RFP, EB plus SM and CAM. The expectoration of M. scrofulaceum was ceased after 4 months of treatment. The common lesion of non-tuberculous mycobacterium is found in the lung. A non-tuberculous mycobacterium infection might accompany with pleural involvement or pleurisy. Thus in case of pleural diseases, non-tuberculous mycobacterium should also be included among differential diagnosis.

Aged↗
PubMed1992

[Study on familial attacks of pulmonary tuberculosis in Sapporo City].

We studied familial attacks of pulmonary tuberculosis in Sapporo City from 1987 to 1990. There were 146 sources of infection. Two hundred twenty three were infected secondly. Chemotherapy was given to the 75 out of 223 patients. Chemoprophylaxis was given to the total of 148 children. The average ages of the sources, those who were infected secondly and those who had given chemoprophylaxis were 44.8, 32.2 and 7.7 years of age respectively. The ratio of male vs female was 1:0.4 among the sources. The main routes of transmission of this disease were from husbands to wives, from fathers to children, and from grandfathers to grandchildren. The patients who did not have health examination in the preceding one year of their present diagnoses had more severe state of disease as well as higher Gaffky degrees and were treated for more than one year. The infectious patients accounted for more than 50% of the active pulmonary tuberculosis in Sapporo City in 1990. Tuberculin skin test has been performed in almost cases of family examination and the period of chemoprophylaxis has been standardized along the guideline for the chemoprophylaxis by Japan Tuberculosis Association and the Ministry of Health and Welfare. Family and relatives of the patient who expectorates tuberculosis bacilli should take at least one examination annually. Younger people should take it more frequently and chemoprophylaxis should be given to the child whose reaction of Tuberculin skin test is strongly positive.

Adolescent↗
PubMed2005

[A field trial for evaluating the safety of recombinant human interferon alpha-2b for nasal spray].

OBJECTIVE: To evaluate the safety of recombinant human interferon alpha-2b for nasal spray for the prevention of SARS and other upper respiratory viral infections. METHODS: Field epidemiologic evaluation was conducted, the design was randomized and had a synchronously parallel control group. In the study, the drugs were given for five days and all subjects were followed up for ten days. RESULTS: During the period of using interferon, body temperature of the experimental group was normal compared to the control group. Experimental group had more influenza-like symptoms than the control group (P < 0.05), such as headache (4.83%-7.09%), dizziness (7.17%-11.63%), lassitude (8.55%-15.06%), muscular soreness (4.43%-7.09%), pharynx dryness (12.10%-17.85%), angina (6.25%-8.72%), abdominal pain (2.30%-5.50%) and diarrhea (2.45%-5.66%). Most of side effects reached their peak with in the first 3 days. Except for pharynx dryness, the incidences of all other side effects declined after completion of the use of the trial drug, and incidences of some symptoms in experimental group were lower than those of the control group. There were no significant differences in the symptoms of cough and expectoration between the experimental group and the control group. The incidence of exanthem in the control group was significantly higher than that in the experimental group. The side effect of bloody nasal mucus was not observed in experimental group, which had been reported by other authors in several volunteer studies. CONCLUSION: Using recombinant human interferon alpha-2b for nasal spray could lead to some influenza-like symptoms, however, all those symptoms were mild , reversible, and relieved after completion of the use of the trial drug. No serious side effects were found during the period of following up. The authors conclude that the drug is safe.

Abdominal Pain↗
PubMed2005

[A case of intratracheal osteoma].

A 75-year-old woman who complained of cough at night and stridor on exertion was admitted for examination of a possible tracheal tumor. Chest radiography and CT showed an intratracheal calcification. Bronchoscopic examination revealed a lobulated tumor on the anterior wall of the trachea, 6 cm below the vocal cord. The tumor was covered with tracheal epithelium. Microscopic findings of the transtracheal biopsy specimen revealed the tumor to be composed of bone tissues covered with normal tracheal epithelium. No cartilage, smooth muscle, or fats tissue were detected, and so a diagnosis of intratracheal osteoma was made. After Nd-YAG laser therapy, the size of the tumor decreased, and clinical findings improved. During periodical follow up after discharge, the residual tumor was expectorated at home on coughing. Histological examination confirmed the tumor to be osteoma. An intratracheal osteoma is very rare, and this case is the first case reported in Japan.

Aged↗
PubMed1992

[A case of re-expansion pulmonary edema following water seal drainage for spontaneous pneumothorax--management with right and left-separated mechanical ventilation].

A 23-year-old male with complete collapse of the right lung due to spontaneous pneumothorax was admitted 11 days after its onset. Paying close attention to the re-expansion pulmonary edema (REPE), water seal drainage was performed. Following couple episodes of persistent severe cough, four hours later, he developed dyspnea and began to expectorate frothy massive sputum. Chest X-ray revealed pulmonary edema of the entire right lung field. Measurement of total proteins and neutrophil elastase in airway exudates showed 5.5 g/dl (ratio to plasma, 0.89) and 7000 micrograms/l, respectively. Because of marked difference of compliance between bilateral lungs, management with right and left-separated mechanical ventilation and PEEP applied only to the right lung was performed. Although transient mediastinal deviation to the left was observed, successful management was achieved by the maneuver. High concentrations of total proteins and neutrophil elastase in edema fluid suggest that increased vascular permeability due to endothelial cell injury via activated neutrophils is mainly responsible for REPE. In the present case, rapid expansion of the collapsed lung accelerated by severe cough seems to be a predisposing factor of REPE. In patient with prolonged pneumothorax, suppression of cough is thought to be important for the prevention of REPE even with water seal drainage.

Adult↗
PubMed2005

Diagnosis and treatment of bacterial pneumonia in liver transplantation recipients: report of 33 cases.

BACKGROUND: Bacterial pneumonia in the recipients of liver transplantation (LTX) is a common postoperative complication influencing the prognosis greatly. In this article, the diagnosis and treatment of bacterial pneumonia in 33 LTX recipients are reported. METHODS: From February 1999 to January 2003, a total of 103 patients underwent allogeneic LTX at our center; afterwards, a retrospective analysis was made on their postoperative clinical manifestations, including symptoms (expectoration, panting and fever), sign (rale), results of laboratory examinations (white blood cell count and sputum culture of tracheal secretions or pleural fluid culture), and chest X-ray films. The following data of the pneumonia and non-pneumonia groups were collected, and the rank sum test (SPSS 11.0, Wilcoxon's method) was used to analyze the duration of postoperative respirator utilization and the volume of pleural effusion through pleurocentesis or pleural drainage. RESULTS: In the 103 patients, 33 experienced 53 episodes of bacterial pneumonia during their hospital stay after transplantation, 14 of them (42.42%) had more than three manifestations of the seven mentioned above. The pathogens causing bacterial pneumonia included Pseudomonas aeruginosa (17.48%), Klebsiella pneumoniae (15.53%), Acinetobacter baumannii (10.68%), and Staphylococcus aureus (7.77%). Amilkacin, tienam, ciprofloxacin, vancomycin, etc. were the antibiotics of choice against those bacteria. Acute rejection occurred during the treatment of bacterial pneumonia in 16 patients, and 5 of them died. Wilcoxon's rank sum test of the data indicated that the pneumonia group had longer duration of postoperative ventilator treatment and larger volume of pleural effusion than the non-pneumonia group (P < 0.05). CONCLUSIONS: The clinical manifestations of pneumonia after LTX might be atypical, and special attention should be paid to the respiratory symptoms and signs within 2 months after LTX. Whenever the diagnosis of bacterial pneumonia is confirmed, consideration should be given to reasonable use of antibiotics and regulation of immunity in addition to other routine therapies.

Adult↗
PubMed2005

[Essential oils for the nutrition of poultry, swine and ruminants].

Essential oils are very complex mixtures of volatile, lipophilic compounds originating from plants. Due to their lipophility they posses a good intestinale and percutane absorption. Under external application essential oils demonstrate antiphlogistic or rubefacient to pro-inflammatority activities. Orally intake they stimulate the secretion of digestive enzymes and increase gastric and intestinal motility. Moreover they show spasmolytic, expectorative and diuretic activities. Besides antimicrobial properties on bacteria and fungi have been observed in vitro and in vivo. Due to their various effects essential oils increasingly gain attention in animal nutrition and are discussed to be alternatives to antibiotic growth promoters. In some studies essential oils have been reported to reduce intestinal pathogens in broilers and piglets. When administered to ruminants essential oils decrease ruminal ammonia production by suppression the growth of deaminative microorganisms. However, the observed effects on growth performance are inconsistent among studies. In conclusion, there are still some unanswered questions concerning the mode of action, metabolic pathway and optimal dosage of essential oils in different animal species. Further scientific research is therefore needed to use essential oils effectivly in livestock feeding.

Animal Feed↗
PubMed2005

Cyclospora cayetanensis oocysts in sputum of a patient with active pulmonary tuberculosis, case report in Ismailia, Egypt.

Observation of acid fast C. cavetanensis oocysts were proved in a sputum sample of a 45 years-old male HIV negative patient who was admitted to Chest Hospital due to loss of weight, cough with expectoration of purulent sputum and dyspnea. The radiological picture suggested active pulmonary tuberculosis (TB). Sputum samples which were positive for acid fast bacilli as proved by Ziehl-Neelsen stain technique showed large (8-10 microm) spherical acid-fast C. cayetanensis oocysts and their identify was confirmed by molecular techniques (Nested PCR). The patient was successfully treated for TB since 4 years. However, this was the second time to report C. cayetanensis oocysts in human sputum. The first one was in Argentina. So, C. cayetanensis is a new respiratory system pathogen which must be considered in the differential diagnosis.

Animals↗
PubMed2005

Experience of surgical therapy in 72 patients with thoracic hydatidosis over a 10-year period.

OBJECTIVE: This review aims to evaluate retrospectively 72 patients diagnosed to have thoracic hydatid disease and treated surgically in Tikur Anbessa Hospital between December 1993 and November 2003. DESIGN: Retrospective Analysis hospital records. SETTINGS: Tikur Anbessa Hospital, Department of Surgery, Medical Faculty, Addis Ababa University, Addis Ababa, Ethiopia. PATIENTS AND METHODS: Medical records and Operation theater registers of seventy-two Patients operated on for Thoracic hydatidosis were evaluated retrospectively. Chest Roentgenogram was the main diagnostic tool used Main surgical techniques employed were evacuation in 44 (52.4%) cysts, cystotomy in 30 (35.7%) cysts, and enucleation in 10 (12%) cysts. Additional palliative procedures (such as pericystectomy and Capitonnage) and radical procedures (such as resection of the lung) were also employed. RESULTS: forty of the patients were male and thirty-two female with a mean age of 31.4 years. The most Common presenting symptoms were cough in 60 (83.3%) patients, expectoration in 47 (65.3%) patients and chest pain in 38 (52.8%) patients. Chest radiography revealed a round opacity or shadow in 58 (80.6%) patients. All patients were treated surgically. The mean hospital stay was 38.3 days. Major postoperative Complications occurred in 12 (16.9%) patients; pneumonia, pleural effusion and prolonged air leak were the complications in order of their frequency. There was one postoperative death and one recurrence at 6-months follow-up period. CONCLUSION: Surgical excision of pulmonary hydatidosis with maximum preservation of lung parenchyma is possible in the majority of patients and should remain the mainstay of surgical treatment.

Adolescent↗
PubMed2005

[Pulmonary fungal infection in malignant hematological diseases: an analysis of 14 cases].

The objective of this study was to evaluate the etiological factors, diagnosis and therapy of pulmonary fungal infection in hematological malignancies, 14 cases of malignant hematological disease with pulmonary fungal infection were collected and analyzed. The results showed that 11 out of 14 cases had the respiratory manifestations, sputum was sticky and difficult to be expectorated in 7 cases, X rays in chests showed shadows with features of stigma and sheet in 11 cases, Candida albicans and aspergillus infection were observed in 10 and 2 cases respectively, the numbers of neutrophil were below 0.5 x 10(9)/L in 8 cases and below 1.0 x 10(9)/L in 3 cases respectively, fluconazole was used for 12 cases and clinical symptoms of 11 cases were improved within two weeks. In conclusion, the occurrence of pulmonary fungal infection in malignant hematological diseases is associated with intensive chemotherapy, decrease of neutrophil counts and using of broad-spectrum antibiotics, the diagnosis at early stage is difficult and clinicians should pay more attention to its clinical and laboratory examinations, and give them therapy in time.

Adolescent↗
PubMed1992

[Therapy of respiratory tract diseases with N-acetylcysteine. An open therapeutic observation study of 2,512 patients].

STUDY DESIGN: Open therapeutic observational study. PATIENTS: 2,510 patients with acute and chronic bronchitis, bronchial asthma, and emphysema. TREATMENT: 4-week treatment with N-acetylcystein administered three times a day 200 mg dissolved (n = 1734) or undissolved (n = 608) or at some other, usually lower, dosage (n = 173). During the f-week treatment phase, any other drugs being taken were neither discontinued nor changed. TARGET PARAMETERS: In addition to 1-sec capacity (FEV1), various, mainly subjective, parameters were noted, in particular coughing, amount and nature of expectorate. RESULTS: for the evaluation, the patients were assigned either to the acute bronchitis or the chronic bronchitis group; the latter group also contained patients with other diseases, such as asthma and emphysema, since such conditions often presented simultaneously. All selected parameters clearly improved under treatment, equally in the acute and chronic bronchitis groups. As expected, the mucolytic effect was very pronounced, the 1-sec capacity increased significantly. No major difference was to be found in the results observed in patients on and those not on other additional medication.

Acetylcysteine↗