Background: The mediastinum is composed primarily of fatty tissue that is surrounded by the lungs bilaterally. There is a lack in the published literature in studying changes in mediastinal fat in idiopathic pulmonary fibrosis (IPF). The purpose of this study was to determine whether the shape and dimensions of the anterior mediastinal fat in patients with IPF are different from that of a normal control group and to correlate the changes with disease severity. Design and Setting: This prospective case control study was done at the chest department of Assiut University Hospital on IPF patients from May 2010-September 2012. A questionnaire containing questions such as age, sex, clinical findings, high resolution computerized tomography (HRCT) score and pulmonary function tests (PFTs) was filled for patients and normal controls. Results: The IPF retrosternal AP dimension was significantly shorter (p = 0.03) and the transverse dimension was longer (p = 0.001) than that in the normal control group. The convex shape of the anterior mediastinum was predictive of IPF (p = 0.001), whereas concave shape was predictive of normal controls (p = 0.001). The change in anteroposterior diameter (AP) and transverse diameters showed significant correlation with the changes in FVC, DLCO and HRCT score. Conclusions: IPF patients had reduced retrosternal AP and increased transverse dimensions than those of the controls with convex shape of their anterior mediastinal fat. Changes in anterior mediastinal fat dimensions are correlated with lower FVC, DLCO and higher HRCT score. A larger sample size, better multicenteric study is needed to confirm the results of this study.
{"title":"Anterior Mediastinal Fat Changes in Idiopathic Pulmonary Fibrosis: A Preliminary Study","authors":"W. Hassan, Eman Abo-Elhamd","doi":"10.4236/OJRD.2014.41003","DOIUrl":"https://doi.org/10.4236/OJRD.2014.41003","url":null,"abstract":"Background: The mediastinum is composed primarily of fatty tissue that is surrounded by the lungs bilaterally. \u0000There is a lack in the published literature in studying changes in mediastinal fat in idiopathic pulmonary fibrosis \u0000(IPF). The purpose of this study was to determine whether the shape and dimensions of the anterior mediastinal fat in patients with IPF are different from that of a normal control group and to correlate the changes with disease severity. Design and Setting: This prospective case control study was done at the chest department of Assiut University Hospital on IPF patients from May 2010-September 2012. A questionnaire containing questions such as age, sex, clinical findings, high resolution computerized tomography (HRCT) score and pulmonary function tests (PFTs) was filled for patients and normal controls. Results: The IPF retrosternal AP dimension was significantly shorter (p = 0.03) and the transverse dimension was longer (p = 0.001) than that in the normal control group. The convex shape of the anterior mediastinum was predictive of IPF (p = 0.001), whereas concave shape was predictive of normal controls (p = 0.001). The change in anteroposterior diameter (AP) and transverse diameters showed significant correlation with the changes in FVC, DLCO and HRCT score. Conclusions: IPF patients had reduced retrosternal AP and increased transverse dimensions than those of the controls with convex shape of their anterior mediastinal fat. Changes in anterior mediastinal fat dimensions are correlated with lower FVC, DLCO and higher HRCT score. A larger sample size, better multicenteric study is needed to confirm the results of this study.","PeriodicalId":83134,"journal":{"name":"The Journal of respiratory diseases","volume":"4 1","pages":"18-21"},"PeriodicalIF":0.0,"publicationDate":"2014-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70583205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
R. Mishra, R. Kulshrestha, S. Chhabra, S. Srivastav, S. Bansal
Background and Objectives: Protein kinase C (PKC) activation plays an important role in activation of T-lymphocytes in asthma. Airway hypersensitivity is one of the main characteristic features of asthma, the mechanism of onset of which is not clearly understood. Therefore, the objective was to elucidate the role of PKC in etiopathogenesis of airway hypersensitivity in asthma. Methods: Male guinea pigs (n = 30) were sensitized with ovalbumin and day of initial allergen-specific immune response determined by intradermal test, airway hypersensitivity, BALF cytology and lung histopathology. Total PKC activity, PKC isoenzymes and phosphoinositides were assessed in airway smooth muscles (ASM) and peripheral blood lymphocytes. Results: Intradermal test revealed that day 9 was the earliest time of allergen-specific response and onset of airway hypersensitivity to ovalbumin. It was associated with significant increase in total and differential (lymphocytes and eosinophils) BALF counts and grade I peribronchiolar chronic lymphocytic inflammation in lung. On day 14, grade II infiltration of lymphocytes and eosinophils with onset ofstructural remodelingofproximal and distal airways was seen. Total PKC activity, expression of PKCα, PKCe and phosphoinositides increased significantly in ASM and lymphocytes on day 9 and were maximum on day 14. There was no change in PKC-τ expression. Conclusions: Activation of PKC, particularly PKCα and PKCe, mediated signal transduction pathway plays a critical role in lymphocyte infiltration and onset of airway hypersensitivity, airway remodeling and asthma pathophysiology. The present study is the first one on the mechanism of the etiopathogenesis of the disease, which shows a direct evidence of the role of PKC mediated pathway in the initiation and onset of airway hypersensitivity in ovalbumin sensitized guinea pig model.
{"title":"Critical Role of Protein Kinase C (PKC) in the Onset of Airway Hypersensitivity in Ova-Sensitized Guinea Pig Model of Asthma","authors":"R. Mishra, R. Kulshrestha, S. Chhabra, S. Srivastav, S. Bansal","doi":"10.4236/OJRD.2014.41001","DOIUrl":"https://doi.org/10.4236/OJRD.2014.41001","url":null,"abstract":"Background and Objectives: Protein kinase C (PKC) activation plays an important role in activation of T-lymphocytes in asthma. Airway hypersensitivity is one of the main characteristic features of asthma, the mechanism of onset of which is not clearly understood. Therefore, the objective was to elucidate the role of PKC in etiopathogenesis of airway hypersensitivity in asthma. Methods: Male guinea pigs (n = 30) were sensitized with ovalbumin and day of initial allergen-specific immune response determined by intradermal test, airway hypersensitivity, BALF cytology and lung histopathology. Total PKC activity, PKC isoenzymes and phosphoinositides were assessed in airway smooth muscles (ASM) and peripheral blood lymphocytes. Results: Intradermal test revealed that day 9 was the earliest time of allergen-specific response and onset of airway hypersensitivity to ovalbumin. It was associated with significant increase in total and differential (lymphocytes and eosinophils) BALF counts and grade I peribronchiolar chronic lymphocytic inflammation in lung. On day 14, grade II infiltration of lymphocytes and eosinophils with onset ofstructural remodelingofproximal and distal airways was seen. Total PKC activity, expression of PKCα, PKCe and phosphoinositides increased significantly in ASM and lymphocytes on day 9 and were maximum on day 14. There was no change in PKC-τ expression. Conclusions: Activation of PKC, particularly PKCα and PKCe, mediated signal transduction pathway plays a critical role in lymphocyte infiltration and onset of airway hypersensitivity, airway remodeling and asthma pathophysiology. The present study is the first one on the mechanism of the etiopathogenesis of the disease, which shows a direct evidence of the role of PKC mediated pathway in the initiation and onset of airway hypersensitivity in ovalbumin sensitized guinea pig model.","PeriodicalId":83134,"journal":{"name":"The Journal of respiratory diseases","volume":"2014 1","pages":"1-11"},"PeriodicalIF":0.0,"publicationDate":"2014-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70583528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. Kastelik, F. Chowdhury, S. Pathmanathan, I. Aslam, J. Hogg, J. Morjaria
Flexible bronchoscopy is a common procedure. Training in bronchoscopy is a complex process involving learning technical skills, understanding indications and contraindications, risks and benefits of the procedure, working within the team and communicating with patients. It is expected that a competent bronchoscopist is able to maneuver the scope through the anatomically complex bronchial tree, take samples, manage the sedated patient and communicate with nursing staff. Learning the complex procedural skills in the clinical setting can be stressful, therefore current bronchoscopic training methodology should blend a number of learning methods including didactic lectures, web-based material, high and low fidelity simulators as well as supervised apprenticeship training. Simulation-based bronchoscopy training therefore has been explored as a mode of training bronchoscopy skills. In this article, the role of simulation-based bronchoscopy training is reviewed. The low fidelity and high fidelity virtual reality bronchoscopy models are described together with the evidence available to support the use of simulation for bronchoscopy training.
{"title":"Developments in Simulation Bronchoscopy Training","authors":"J. Kastelik, F. Chowdhury, S. Pathmanathan, I. Aslam, J. Hogg, J. Morjaria","doi":"10.4236/OJRD.2013.34024","DOIUrl":"https://doi.org/10.4236/OJRD.2013.34024","url":null,"abstract":"Flexible bronchoscopy is a common procedure. Training in bronchoscopy is a complex process involving learning technical skills, understanding indications and contraindications, risks and benefits of the procedure, working within the team and communicating with patients. It is expected that a competent bronchoscopist is able to maneuver the scope through the anatomically complex bronchial tree, take samples, manage the sedated patient and communicate with nursing staff. Learning the complex procedural skills in the clinical setting can be stressful, therefore current bronchoscopic training methodology should blend a number of learning methods including didactic lectures, web-based material, high and low fidelity simulators as well as supervised apprenticeship training. Simulation-based bronchoscopy training therefore has been explored as a mode of training bronchoscopy skills. In this article, the role of simulation-based bronchoscopy training is reviewed. The low fidelity and high fidelity virtual reality bronchoscopy models are described together with the evidence available to support the use of simulation for bronchoscopy training.","PeriodicalId":83134,"journal":{"name":"The Journal of respiratory diseases","volume":"2013 1","pages":"154-163"},"PeriodicalIF":0.0,"publicationDate":"2013-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70583261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Redwan, R. Gatz, N. Hassan, H. Matter, A. Hammodi, A. Attia
Objective: The traditional approach for acid base interpretation is based on Handerson-Hasselbalch formula and includes Base Excess (BE), bicarbonate (HCO3), albumin corrected anion gap. The Physicochemical approach is centered on the Carbon Dioxide tension (PCO2), the strong ion difference (SID), strong ion gap (SIG) = SID apparent-SID effective and totally weak acids (Atot). The study aims to compare between the traditional approach and the physicochemical approach in acid base disorder interpretation. Design: Prospective observational study in an adult Intensive Care Unit (ICU) recruiting six hundred and sixty one patients. Methods: Arterial blood samples were analyzed to measure pH, PaCO2 sodium, potassium, chloride and lactate. Venous blood samples were analyzed to measure ionized calcium, magnesium, phosphorous and albumin. These samples were interpreted by both techniques. Results: Normal HCO3 and BE were detected by traditional approach in 49 cases of which SIG acidosis was detected in 22 cases (46%) and Hyperchloremic acidosis was detected in 29 cases (60%) by physicochemical method. SIG was elevated in 72 cases (58%) of 124 cases with high anion gap acidosis. SIDeff and BE were strongly correlated, r = 0.8, p 0.0001, while SIG and Albumin corrected Anion Gap (ALAG) were moderately correlated r = 0.56, p Conclusion: Both approaches are important for interpretation of the acid base status. Traditional approach identifies the diagnostic description without many calculations and detects body compensatory response to acid base disorders. Physicochemical approach is essential to identify the exact causation and the severity of the acid base disorders.
{"title":"Comparative Study between Traditional Approach and Physico-Chemical Approach in Acid Base Disorders Interpretation in Critically Ill Patients","authors":"A. Redwan, R. Gatz, N. Hassan, H. Matter, A. Hammodi, A. Attia","doi":"10.4236/OJRD.2013.34022","DOIUrl":"https://doi.org/10.4236/OJRD.2013.34022","url":null,"abstract":"Objective: The traditional approach \u0000for acid base interpretation is based on Handerson-Hasselbalch formula and includes Base \u0000Excess (BE), bicarbonate (HCO3), albumin corrected \u0000anion gap. The Physicochemical approach is centered on the Carbon Dioxide \u0000tension (PCO2), the strong ion difference (SID), strong ion gap (SIG) = SID \u0000apparent-SID effective and totally weak acids (Atot). The study aims to \u0000compare between the traditional approach and the physicochemical approach in \u0000acid base disorder interpretation. Design: Prospective \u0000observational study in an adult Intensive Care Unit (ICU) recruiting six \u0000hundred and sixty one patients. Methods: Arterial blood samples were analyzed to measure pH, PaCO2 sodium, potassium, chloride and lactate. Venous blood \u0000samples were analyzed to measure ionized calcium, magnesium, phosphorous and albumin. These samples were interpreted by both techniques. Results: Normal HCO3 and BE were \u0000detected by traditional approach in 49 cases of which SIG acidosis was detected \u0000in 22 cases (46%) and Hyperchloremic acidosis was detected in 29 cases (60%) by \u0000physicochemical method. SIG was elevated in 72 cases (58%) of 124 cases with \u0000high anion gap acidosis. SIDeff and BE were strongly correlated, r = 0.8, p 0.0001, \u0000while SIG and Albumin corrected Anion Gap (ALAG) were moderately correlated r = \u00000.56, p Conclusion: Both approaches are \u0000important for interpretation of the acid base status. Traditional approach \u0000identifies the diagnostic description without many calculations and detects body \u0000compensatory response to acid base disorders. Physicochemical approach is essential \u0000to identify the exact causation and the severity of the acid base disorders.","PeriodicalId":83134,"journal":{"name":"The Journal of respiratory diseases","volume":"03 1","pages":"143-149"},"PeriodicalIF":0.0,"publicationDate":"2013-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70582882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Emilie Lavoie-Charland, Jean‐Christophe Bérubé, M. Laviolette, L. Boulet, Y. Bossé
Background and Objectives: Asthma is a heterogeneous disease where patient severity can be classified according to various models based on numerous variables. Large collections of well-phenotyped subjects are needed to find distinct clusters of patients for personalized medicine and future genetic studies. The objective of this study is to describe the collection of the Quebec City Case-Control Asthma Cohort and to identify homogeneous subgroups of asthma patients based on clinical characteristics. Methods: This cohort is part of an ongoing project initiated in 2007 to elucidate the genetic basis of asthma. All subjects are randomly recruited at the same site following advertisements. Subjects are unrelated French Canadian white adults 18 years of age or older. Each participant underwent a spirometry, methacholine challenge, and allergy skin-prick tests. Blood was collected for DNA, cell counts and total serum IgE measurements. So far, 982 subjects have been recruited and classified as cases (n = 566) or controls (n = 416). We performed factor and cluster analyses on collected phenotypes from this set to identify subgroups of phenotypically similar asthmatic patients. Results: Factor analysis with 13 variables led to the selection of five factors: lung function, numbers of allergens, blood eosinophil percentage, smoking status and age. K-means cluster analysis on the reduced dataset produced four significantly different groups with the following characteristics: smoking history, low atopy and low lung function, high atopy, and young non-smoking with average atopy. Conclusions: The Quebec City Case-Control Asthma Cohort is a new resource for local and collaborative clinical and genetic research on asthma. This new collection reveals distinct multivariate phenotypes of adult asthma that are likely to be important for future genetic studies and targeted therapies.
{"title":"Multivariate Asthma Phenotypes in Adults: The Quebec City Case-Control Asthma Cohort","authors":"Emilie Lavoie-Charland, Jean‐Christophe Bérubé, M. Laviolette, L. Boulet, Y. Bossé","doi":"10.4236/OJRD.2013.34021","DOIUrl":"https://doi.org/10.4236/OJRD.2013.34021","url":null,"abstract":"Background and Objectives: Asthma is a heterogeneous disease where patient severity can be classified according to various models based on numerous variables. Large collections of well-phenotyped subjects are needed to find distinct clusters of patients for personalized medicine and future genetic studies. The objective of this study is to describe the collection of the Quebec City Case-Control Asthma Cohort and to identify homogeneous subgroups of asthma patients based on clinical characteristics. Methods: This cohort is part of an ongoing project initiated in 2007 to elucidate the genetic basis of asthma. All subjects are randomly recruited at the same site following advertisements. Subjects are unrelated French Canadian white adults 18 years of age or older. Each participant underwent a spirometry, methacholine challenge, and allergy skin-prick tests. Blood was collected for DNA, cell counts and total serum IgE measurements. So far, 982 subjects have been recruited and classified as cases (n = 566) or controls (n = 416). We performed factor and cluster analyses on collected phenotypes from this set to identify subgroups of phenotypically similar asthmatic patients. Results: Factor analysis with 13 variables led to the selection of five factors: lung function, numbers of allergens, blood eosinophil percentage, smoking status and age. K-means cluster analysis on the reduced dataset produced four significantly different groups with the following characteristics: smoking history, low atopy and low lung function, high atopy, and young non-smoking with average atopy. Conclusions: The Quebec City Case-Control Asthma Cohort is a new resource for local and collaborative clinical and genetic research on asthma. This new collection reveals distinct multivariate phenotypes of adult asthma that are likely to be important for future genetic studies and targeted therapies.","PeriodicalId":83134,"journal":{"name":"The Journal of respiratory diseases","volume":"3 1","pages":"133-142"},"PeriodicalIF":0.0,"publicationDate":"2013-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70582756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In this paper, feasibility of web based breathing exercises for respiratory rehabilitation is examined. A system included visual guidance in a web browser and a microphone equipped headset for biofeedback and interaction. Feasibility was assessed in a controlled environment on 34 subjects with anxiety disorders that were not offered any help from the personnel. Weak points of comprehensibility were identified as applying headset (21%) and adhering to breathing exercises instructions (7%). No adverse events were identified. Design flaws that correlated with poor user’s experience were 1) the unpleasant feelings induced by watching the computer screen (21%) and 2) ease/difficulty of physically applying headset (14%). We conclude that conducting breathing exercises by using an acoustic microphone and a web browser is feasible and should be further researched. Additionally we conclude that audio feedback might be more pleasant to some people.
{"title":"Respiratory Physiotherapy in a Web Browser, Feasibility Study","authors":"M. Leskovsek, M. Lasič, Dragomira Ahlin","doi":"10.4236/OJRD.2013.34023","DOIUrl":"https://doi.org/10.4236/OJRD.2013.34023","url":null,"abstract":"In this paper, feasibility of web based breathing exercises \u0000for respiratory rehabilitation is examined. A system included visual guidance \u0000in a web browser and a microphone equipped headset for biofeedback and \u0000interaction. Feasibility was assessed in a controlled environment on 34 \u0000subjects with anxiety disorders that were not offered any help from the personnel. \u0000Weak points of comprehensibility were identified as applying headset (21%) and \u0000adhering to breathing exercises instructions (7%). No adverse events were \u0000identified. Design flaws that correlated with poor user’s experience were 1) \u0000the unpleasant feelings induced by watching the computer screen (21%) and 2) \u0000ease/difficulty of physically applying headset (14%). We conclude that \u0000conducting breathing exercises by using an acoustic microphone and a web \u0000browser is feasible and should be further researched. Additionally we conclude \u0000that audio feedback might be more pleasant to some people.","PeriodicalId":83134,"journal":{"name":"The Journal of respiratory diseases","volume":"03 1","pages":"150-153"},"PeriodicalIF":0.0,"publicationDate":"2013-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70583116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
E. Pefura-Yone, N. F. Kanko-Nguekam, A. Kengne, A. Balkissou, A. Noseda, C. Kuaban
Background: Spirometric reference values vary substantially across ethnic groups, and remain largely poorly characterized among Africans. We derived spirometric reference equations for adult Cameroonians and compared their performance with those derived from other ethnic groups. Methods: Spirometric variables according to the American Thoracic Society/European Respiratory Society 2005 guidelines were acquired in voluntary healthy non-smoker subjects in Yaounde (Capital City) and Foumbot (semi-urban area in West Region), in Cameroon during November 2011 to January 2012 (Yaounde) and August 2012 (Foumbot). Reference equations were derived separately for men and women from multiple linear regressions. Results: A total of 411 subjects (206 men) met the inclusion criteria. The mean age was 39.5 ± 16.1 years (min - max: 18 - 85 years) for men and 39.2 ± 14.1 years (18 - 90 years) for women. Age and height were the only variables significantly associated with spirometric values in the final linear regression models. Derived reference values were lower than those derived from Global Lung Initiative 2012 equations for different ethnic groups, except for the forced expiratory volume in 1 second/forced vital capacity ratio (FEV1/FVC ratio). The mean FEV1/FVC ratio was 0.88 ± 0.07 for Cameroonian men and 0.89 ± 0.07 for Cameroonian women. Variations in the performance of derived models in bootstrap internal validation were marginal. Conclusion: This study highlights the importance of deriving specific predictive equations for each ethnic group. The use of adjustment factors applied to Caucasian equations when compared with the values derived in our study leads to an overestimation of the values for FEV1 and FVC.
{"title":"Spirometric Reference Equations for Semi-Urban and Urban Bantu Cameroonians","authors":"E. Pefura-Yone, N. F. Kanko-Nguekam, A. Kengne, A. Balkissou, A. Noseda, C. Kuaban","doi":"10.4236/OJRD.2013.34025","DOIUrl":"https://doi.org/10.4236/OJRD.2013.34025","url":null,"abstract":"Background: Spirometric reference values vary substantially across ethnic groups, and remain largely poorly characterized among Africans. We derived spirometric reference equations for adult Cameroonians and compared their performance with those derived from other ethnic groups. Methods: Spirometric variables according to the American Thoracic Society/European Respiratory Society 2005 guidelines were acquired in voluntary healthy non-smoker subjects in Yaounde (Capital City) and Foumbot (semi-urban area in West Region), in Cameroon during November 2011 to January 2012 (Yaounde) and August 2012 (Foumbot). Reference equations were derived separately for men and women from multiple linear regressions. Results: A total of 411 subjects (206 men) met the inclusion criteria. The mean age was 39.5 ± 16.1 years (min - max: 18 - 85 years) for men and 39.2 ± 14.1 years (18 - 90 years) for women. Age and height were the only variables significantly associated with spirometric values in the final linear regression models. Derived reference values were lower than those derived from Global Lung Initiative 2012 equations for different ethnic groups, except for the forced expiratory volume in 1 second/forced vital capacity ratio (FEV1/FVC ratio). The mean FEV1/FVC ratio was 0.88 ± 0.07 for Cameroonian men and 0.89 ± 0.07 for Cameroonian women. Variations in the performance of derived models in bootstrap internal validation were marginal. Conclusion: This study highlights the importance of deriving specific predictive equations for each ethnic group. The use of adjustment factors applied to Caucasian equations when compared with the values derived in our study leads to an overestimation of the values for FEV1 and FVC.","PeriodicalId":83134,"journal":{"name":"The Journal of respiratory diseases","volume":"3 1","pages":"164-174"},"PeriodicalIF":0.0,"publicationDate":"2013-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70583360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. Hull, I. Barton, J. Torgersen, Christine Marie McNeil
Introduction: Acute Upper Respiratory Tract Infections (URTIs) are the most common infectious diseases of humankind. While usually mild and self-limiting, they are characterized by a series of simultaneously occurring symptoms/ signs that are sufficiently disruptive to sufferers’ normal activities in which medication is frequently sought. While the literature has many examples of epidemiological studies on these infections, there are few reports on patient experience and impact. This study was designed to investigate these aspects of Common Cold/Flu across six countries. Methods: A minimum of 500 adults aged 18 and older were recruited in each of six countries (Brazil, China, Germany, India, Russia, and the US) using customary survey research sampling techniques. Single 30-minute (online) or 40-minute door-to-door quantitative questionnaires with c. 50 questions were completed with each participant by the global research firm Ipsos. Main Findings: Across countries, incidence and seasonality of infections reported to this study were consistent with published data. There appears to be a need for patient education on the causes and transmission routes of respiratory infections. Getting good quality sleep and being able to continue with daily activities as an infection resolves are significant drivers to therapy. The most common non-prescription therapies reported were multi-ingredient products in line with the simultaneously occurring multi-symptom nature of the condition(s). Conclusions: This study indicated that acute URTIs exert a significant deleterious effect on sufferers. Public health education, possibly best undertaken by Pharmacists has the potential to impact the extent of virus transmission by ensuring that people know the true cause of the infection, how it is transmitted and how best to combat this. The several simultaneously occurring symptoms encourage sufferers to seek multi-ingredient remedies to allow them to continue with normal activities as their infection resolves naturally.
{"title":"A Survey of the Experience and Impact of Acute Upper Respiratory Tract Infections on People in Six Countries in the 2011/2012 Common Cold and Flu Season","authors":"J. Hull, I. Barton, J. Torgersen, Christine Marie McNeil","doi":"10.4236/OJRD.2013.34026","DOIUrl":"https://doi.org/10.4236/OJRD.2013.34026","url":null,"abstract":"Introduction: Acute Upper Respiratory Tract Infections (URTIs) are the most common infectious diseases of humankind. While usually mild and self-limiting, they are characterized by a series of simultaneously occurring symptoms/ signs that are sufficiently disruptive to sufferers’ normal activities in which medication is frequently sought. While the literature has many examples of epidemiological studies on these infections, there are few reports on patient experience and impact. This study was designed to investigate these aspects of Common Cold/Flu across six countries. Methods: A minimum of 500 adults aged 18 and older were recruited in each of six countries (Brazil, China, Germany, India, Russia, and the US) using customary survey research sampling techniques. Single 30-minute (online) or 40-minute door-to-door quantitative questionnaires with c. 50 questions were completed with each participant by the global research firm Ipsos. Main Findings: Across countries, incidence and seasonality of infections reported to this study were consistent with published data. There appears to be a need for patient education on the causes and transmission routes of respiratory infections. Getting good quality sleep and being able to continue with daily activities as an infection resolves are significant drivers to therapy. The most common non-prescription therapies reported were multi-ingredient products in line with the simultaneously occurring multi-symptom nature of the condition(s). Conclusions: This study indicated that acute URTIs exert a significant deleterious effect on sufferers. Public health education, possibly best undertaken by Pharmacists has the potential to impact the extent of virus transmission by ensuring that people know the true cause of the infection, how it is transmitted and how best to combat this. The several simultaneously occurring symptoms encourage sufferers to seek multi-ingredient remedies to allow them to continue with normal activities as their infection resolves naturally.","PeriodicalId":83134,"journal":{"name":"The Journal of respiratory diseases","volume":"3 1","pages":"175-187"},"PeriodicalIF":0.0,"publicationDate":"2013-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70583465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: The breathing intolerance index, BIT, a noninvasive derivation of the tension-time index of respiratory muscles, has been recently used to evaluate patients with respect to their need for noninvasive ventilation. Comparing the BIT index in different disorders with mild to moderate respiratory impairment, such as COPD and obesity, would be useful in determining differences in threshold for respiratory muscle fatigue amongst cohorts. Objectives: The purpose of this study was to compare control of ventilation and BIT in individuals with obesity, chronic obstructive pulmonary disease (COPD), and control subjects free of cardiorespiratory disorders. Because change in posture can alter respiratory load and control of ventilation, variables were assessed in two postures. Methods: We assessed 142 subjects consisting of 81 with obesity, 42 with COPD, and 19 non-smoking healthy adults. All subjects underwent evaluation of pulmonary function, control of ventilation and BIT index [(Ti/Ttot) × (Vt/FVC)] in seated and supine postures. Findings: BIT index was significantly greater in seated posture in all 3 cohorts due primarily to an increase in Vt in this position. BIT index was similar in value amongst cohorts in both postures, but tended to be higher in patients with obesity and COPD. Conclusion: While BIT index is higher in seated posture, and tends to be higher in patients with obesity and COPD as compared to control subjects, discrimination between cohorts is not found in our study because of small inter-group variations of respiratory function amongst cohorts. Thus, in clinically stable patients whose vital capacities are mild to moderately reduced, the BIT index alone cannot be recommended as a predictive guide for initiating assisted ventilation for respiratory failure. Nevertheless, because it is easy to perform, and is comfortably tolerated by patients, its potential usefulness may be in periodic measurements to monitor its increase as respiratory reserve declines.
{"title":"Breathing Intolerance Index in COPD and Obesity: A Comparative Observational Study","authors":"A. Baydur, Zhanghua Chen","doi":"10.4236/OJRD.2013.33019","DOIUrl":"https://doi.org/10.4236/OJRD.2013.33019","url":null,"abstract":"Background: The breathing intolerance index, BIT, a noninvasive derivation of the tension-time index of respiratory muscles, has been recently used to evaluate patients with respect to their need for noninvasive ventilation. Comparing the BIT index in different disorders with mild to moderate respiratory impairment, such as COPD and obesity, would be useful in determining differences in threshold for respiratory muscle fatigue amongst cohorts. Objectives: The purpose of this study was to compare control of ventilation and BIT in individuals with obesity, chronic obstructive pulmonary disease (COPD), and control subjects free of cardiorespiratory disorders. Because change in posture can alter respiratory load and control of ventilation, variables were assessed in two postures. Methods: We assessed 142 subjects consisting of 81 with obesity, 42 with COPD, and 19 non-smoking healthy adults. All subjects underwent evaluation of pulmonary function, control of ventilation and BIT index [(Ti/Ttot) × (Vt/FVC)] in seated and supine postures. Findings: BIT index was significantly greater in seated posture in all 3 cohorts due primarily to an increase in Vt in this position. BIT index was similar in value amongst cohorts in both postures, but tended to be higher in patients with obesity and COPD. Conclusion: While BIT index is higher in seated posture, and tends to be higher in patients with obesity and COPD as compared to control subjects, discrimination between cohorts is not found in our study because of small inter-group variations of respiratory function amongst cohorts. Thus, in clinically stable patients whose vital capacities are mild to moderately reduced, the BIT index alone cannot be recommended as a predictive guide for initiating assisted ventilation for respiratory failure. Nevertheless, because it is easy to perform, and is comfortably tolerated by patients, its potential usefulness may be in periodic measurements to monitor its increase as respiratory reserve declines.","PeriodicalId":83134,"journal":{"name":"The Journal of respiratory diseases","volume":"03 1","pages":"119-127"},"PeriodicalIF":0.0,"publicationDate":"2013-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70582938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nazish Fatima, M. Shameem, A. Malik, P. Khan, F. Shujatullah, Sohail Ahmed, Nabeela nbsp
Rheumatoid arthritis (RA) is a chronic systemic disease of unknown etiology characterized by articular involvement, extra-articular involvement, and the presence of serum rheumatoid factor. Pulmonary involvement in RA is a common extra-articular manifestation of rheumatoid arthritis (RA) that confers significant morbidity and mortality. We undertook this study to determine the prevalence and spectrum of pulmonary abnormalities in patients with rheumatoid arthritis (RA) from a North Indian town. 62 patients who met the American College of Rheumatology (formerly the American Rheumatism Association) 1987 classification criteria for RA were subjected to clinical examination of chest, X-Ray-chest (CXR), pulmonary function tests (PFT) and high resonance computed tomography (HRCT). 40.3% patients had some pulmonary symptoms with exertional dyspnoea in 21%, cough with expectoration in 17.7%, fine respiratory rales in 11.3%, patients X-ray chest bilateral lower zone haziness in 16% and prominent pulmonary vasculature in 3.2%. 43% had abnormal PFT-restrictive pattern in 29%, obstructive pattern 8% and mixed pattern in 6.4%. HRCT revealed abnormal findings in 33.8% commonest being ground glass pattern in both lower lobes 19.3%, sub pleural reticulations in 9.6%, pleural thickening in 3.2% and pulmonary vascular prominence in 1.6%. To provide optimal treatment, physicians must always consider the possibility of associated pulmonary manifestations when patients with RA are evaluated.
{"title":"A Study on the Pulmonary Manifestations of Rheumatoid Arthritis from a North Indian Town","authors":"Nazish Fatima, M. Shameem, A. Malik, P. Khan, F. Shujatullah, Sohail Ahmed, Nabeela nbsp","doi":"10.4236/OJRD.2013.33020","DOIUrl":"https://doi.org/10.4236/OJRD.2013.33020","url":null,"abstract":"Rheumatoid arthritis (RA) is \u0000a chronic systemic disease of unknown etiology characterized by articular \u0000involvement, extra-articular involvement, and the presence of serum rheumatoid \u0000factor. Pulmonary involvement in RA is a common extra-articular manifestation of rheumatoid \u0000arthritis (RA) that confers significant morbidity and mortality. We undertook \u0000this study to determine the prevalence and spectrum of \u0000pulmonary abnormalities in patients with rheumatoid arthritis (RA) from a North \u0000Indian town. 62 patients who met the American College of Rheumatology (formerly the American \u0000Rheumatism Association) 1987 classification criteria for RA were subjected to clinical examination of chest, X-Ray-chest (CXR), \u0000pulmonary function tests (PFT) and high resonance computed tomography (HRCT). \u000040.3% patients had some pulmonary symptoms with exertional dyspnoea in 21%, \u0000cough with expectoration in 17.7%, fine respiratory rales in 11.3%, patients \u0000X-ray chest bilateral lower zone haziness in 16% and prominent pulmonary \u0000vasculature in 3.2%. 43% had abnormal PFT-restrictive pattern \u0000in 29%, obstructive pattern 8% and mixed pattern in 6.4%. HRCT revealed \u0000abnormal findings in 33.8% commonest being ground glass pattern in both lower \u0000lobes 19.3%, sub pleural reticulations in 9.6%, pleural thickening in 3.2% and \u0000pulmonary vascular prominence in 1.6%. To provide optimal treatment, physicians \u0000must always consider the possibility of associated pulmonary manifestations \u0000when patients with RA are evaluated.","PeriodicalId":83134,"journal":{"name":"The Journal of respiratory diseases","volume":"2013 1","pages":"128-131"},"PeriodicalIF":0.0,"publicationDate":"2013-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70583055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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