scholarly journals Effects of short-term smoking on lung function and airway hyper-responsiveness in young patients with untreated intermittent adult-onset asthma: retrospective cross-sectional study at a primary–tertiary care hospital in Japan

BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e023450
Author(s):  
Kentaro Watai ◽  
Kiyoshi Sekiya ◽  
Hiroaki Hayashi ◽  
Yuma Fukutomi ◽  
Masami Taniguchi
Keyword(s):  
Lung Function ◽  
Young Patients ◽  
Cross Sectional Study ◽  
Smoking History ◽  
Daily Smoking ◽  
Secondary Outcome ◽  
Adult Onset ◽  
Short Term ◽  
Cross Sectional ◽  
Smoking Duration

ObjectiveIn daily clinical practice, smokers with asthma and with intermittent disease severity are frequently encountered. The effects of short-term smoking on lung function or disease presentation in younger patients with intermittent adult-onset asthma remain unclear. We sought to clarify the effects of short-term smoking (<10 pack-years) on lung function and airway hyper-responsiveness (AHR) in young patients with untreated intermittent adult-onset asthma.DesignRetrospective, cross-sectional study.SettingA single primary–tertiary medical centre in Japan.ParticipantsFrom patients who underwent bronchodilator reversibility tests between January 2004 and March 2011 (n=7291), 262 consecutive patients (age, 20–34 years) with untreated intermittent adult-onset asthma, including 157 never smokers and 105 current smokers within 10 pack-years, were analysed.Primary and secondary outcome measuresThe primary outcome was the association of the daily smoking frequency (number of cigarettes per day), smoking duration (years) and cumulative smoking history (pack-years) with postbronchodilator lung function. The secondary outcome was the association of the former three smoking parameters with AHR.ResultsThe daily smoking frequency, smoking duration and cumulative smoking history were significantly associated with decreased postbronchodilator lung function. Daily smoking of ≥11 cigarettes per day was also associated with marked AHR (OR 2.23; 95% CI 1.03 to 4.80), even after adjustment for age, sex, disease duration and body mass index.ConclusionShort-term active smoking in early adulthood may be associated with decreased lung function and AHR, even in patients with intermittent adult-onset asthma. Our findings suggest a benefit of never smoking, even for young patients with intermittent adult-onset asthma.

scholarly journals Recurrent wheeze and its relationship with lung function and airway inflammation in preschool children: a cross-sectional study in South Korea

BMJ Open ◽  
2017 ◽  
Vol 7 (10) ◽  
pp. e018010 ◽  
Author(s):  
Ji Eun Soh ◽  
Kyung-Moon Kim ◽  
Ji-Won Kwon ◽  
Hyung Young Kim ◽  
Ju-Hee Seo ◽  
...  
Keyword(s):  
Preschool Children ◽  
Lung Function ◽  
Airway Inflammation ◽  
Allergic Diseases ◽  
Cross Sectional Study ◽  
Secondary Outcome ◽  
Sectional Study ◽  
Cross Sectional ◽  
Airway Function ◽  
Recurrent Wheeze

BackgroundRelationship between recurrent wheeze and airway function and inflammation in preschool children is not fully known.ObjectiveTo investigate the relationship between recurrent wheeze and airway inflammation, lung function, airway hyper-reactivity (AHR) and atopy in preschool children.DesignObservational study, comparing forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and mid-forced expiratory flow (FEF25%–75%), dose–response slope (DRS), exhaled nitric oxide (eNO) and atopic sensitisation between children with recurrent wheeze and those without.SettingPopulation-based, cross-sectional study in Seoul and the Gyeonggi province of Korea conducted as a government-funded programme to perform standardised measurement of the prevalence of allergic diseases, and related factors, in preschool children.Participants900 children aged 4–6 years.Primary and secondary outcome measureseNO, FEV1/FVC, FEF25%–75%, DRS, atopic sensitisation and allergic diseases.MethodsChildren completed the modified International Study of Asthma and Allergies in Childhood questionnaire and underwent eNO assessments, spirometry, methacholine bronchial provocation tests and skin prick tests. Recurrent wheeze was defined as having a lifetime wheeze of more than three episodes, based on the questionnaire. The frequency of hospitalisation and emergency room visits was also obtained by means of the questionnaire. ‘Current’ wheeze was defined as having symptoms or treatments within the past 12 months.ResultsThe prevalence of recurrent wheeze was 13.4%. Children with recurrent wheeze showed a higher prevalence of lifetime or current allergic rhinitis (p=0.01 and p=0.002, respectively) and lifetime atopic dermatitis (p=0.007). Children with recurrent wheeze showed lower FEV1/FVC (p=0.033) and FEF25%–75%(p=0.004), and higher eNO levels (p=0.013) than those without recurrent wheeze. However, the DRS, prevalence of atopic sensitisation and serum IgE levels were not significantly different between the two groups.ConclusionsRecurrent wheeze in preschool children may be associated with airway inflammation and diminished airway function, but not with AHR or atopy.

scholarly journals Chronic Respiratory Symptoms and Lung Function of Farmer and Breeder in UTU Village, Tabanan, Bali

2020 ◽  
Vol 8 (B) ◽  
pp. 709-715
Author(s):  
Ni Luh Putu Eka Arisanti ◽  
Ni Putu Ayu Widiasari ◽  
Ida Bagus Ngurah Rai
Keyword(s):  
Lung Function ◽  
Respiratory Symptoms ◽  
Vital Capacity ◽  
Cross Sectional Study ◽  
Forced Expiratory Volume ◽  
Smoking History ◽  
Sectional Study ◽  
Lung Function Decline ◽  
Cross Sectional ◽  
Passive Smoker

AIM: The objective of the study was to determine chronic respiratory symptoms and lung function of farmers. METHODS: The study was conducted in Utu Village, Tabanan, Bali with 84 subjects. This research was observational analytic cross sectional study. RESULTS: Three dominant chronic respiratory symptoms in farmers were coughing (15.1%), dyspnea (13.1%), and phlegm (13.1%). Average values of forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), and FEV1/FVC were 83.75 ± 34.42, respectively, 81.62 ± 34.30 and 104.90 ± 13.90, respectively. Cough was dominant experiencing by smokers (p = 0.008). Mean of FEV1% prediction and FVC% prediction value was lower in passive smoker group than no smoker group (p = 0.005 and p = 0.03). CONCLUSION: Occupational exposure while farming and raising livestock can cause chronic respiratory symptom and lung function decline in farmers and can be influenced by smoking history and secondhand smoke exposure.

Asthma-COPD Overlap (ACO) among Adult-onset Asthma Patients

2020 ◽  
Vol 16 (1) ◽  
pp. 66-70
Author(s):  
Daniel Maranatha ◽  
Nurkristi Permatasari Amin
Keyword(s):  
Pulmonary Function Tests ◽  
Cross Sectional Study ◽  
Smoking History ◽  
Total Serum ◽  
Cumulative Number ◽  
Adult Onset ◽  
Cross Sectional ◽  
Prick Test ◽  
Asthma Patients ◽  
History Of

Background: Asthma and asthma-COPD overlap (ACO) are heterogeneous airway obstruction. This study aims to differentiate ACO and adult-onset asthma based on pulmonary function tests, smoking history, and atopic status. Methods: This cross-sectional study of adult-onset asthma evaluated characteristics, such as bronchodilator reversibility test, the skin prick test, total serum IgE, and serum IL-13 levels of asthma patients who were current/former smokers with a smoking history of <10 packs-year and ≥10 packs-year and who also had taken FEV1 / FVC <0.7 post-bronchodilator. Results: The data of 30 subjects were analyzed and divided into two groups (23 asthma and 7 ACO subjects). The ACO patients were older compared to asthma patients (63.4 ± 4.7 vs. 53.7 ± 7.7, p = 0.004). A higher percentage of men was found in ACO than in asthma (85.7% vs. 21.7%, p = 0.004). There was a difference in the cumulative number of cigarettes consumed in patients with ACO and asthma (19.4 ± 6.4 vs. 7.2 ± 2.6, p = 0.014). The ratio of FEV1 / FVC post-bronchodilator in ACO patients was significantly lower than in asthma patients (57.3 ± 6.9 vs. 65.5 ± 8.8, p = 0.033). There was no difference in the duration of the disease between ACO and asthma (7.2 ± 6.1 vs. 6.1 ± 5.5, p = 0.535). Conclusion: Differences were seen in the number of cigarettes consumed and the ratio of FEV1/FVC in ACO and adult-onset asthma patients. The cumulative number of cigarettes consumed could be a distinguishing characteristic between ACO and asthma.

Desigualdade social em doentes renais crônicos/ Social inequality in chronic renal patients

1970 ◽  
Vol 1 (1) ◽  
pp. 44-49
Author(s):  
Beatriz Bertolaccini Martínez ◽  
Fernanda Marcelino Da Silva ◽  
Vinícius Tavares Veiga ◽  
Rodrigo Pereira Custódio ◽  
José Vítor Da Silva
Keyword(s):  
Social Inequality ◽  
Access To Health Care ◽  
Young Patients ◽  
Cross Sectional Study ◽  
Access To Health Services ◽  
Access To Treatment ◽  
Cross Sectional ◽  
Economic Class ◽  
Access To Health ◽  
Clinical Background

Introdução: A pobreza influencia na evolução dos pacientes com doenças crônicas, porque contribui para o seu agravamento e dificulta o acesso à assistência médica. O objetivo deste trabalho foi avaliar os aspectos relacionados à desigualdade social de pacientes em hemodiálise. Métodos: Estudo transversal com 123 pacientes em hemodiálise no Hospital Samuel Libânio – Pouso Alegre, MG, divididos, de acordo com a classe econômica, em 3 grupos: AB (n=23), C (n=60) e DE (n=40),. Foram coletados dados sociodemográficos e econômicos, antecedentes clínicos e informações sobre o acesso a serviços de saúde. Para a análise dos resultados, foi utilizada estatística analítica e descritiva. Adotou-se p £ 0,05. Resultados: O grupo AB apresentou um menor número de pacientes jovens (4,3% em AB vs 40% em C e 25% em DE, p < 0,05), um maior número de indivíduos com mais anos de escolaridade (65,3% em AB vs 18,3% em C e 2,5% em DE; p < 0,05), predomínio de pacientes com menos de um ano em tratamento de hemodiálise (65,2% em AB vs 10% em C e 5% em DE, p < 0,05), menor número de usuários do SUS (40% em C e 25% em DE vs 4,3% em AB; p < 0,05) e maior acesso ao tratamento com nefrologista (73,9% em AB vs 46,7% em C e 52,5 em DE; p < 0,05). Conclusão: Classes economicamente desfavorecidas agregam indivíduos mais jovens, com menor escolaridade, usuários do SUS, com maior tempo em hemodiálise e pior acesso ao tratamento com nefrologista.Introduction: The poverty influence on the evolution of patients with chronic diseases because it contributes to your aggravation and hinders access to health care. Our goal was to evaluate the aspects related to social inequality on hemodialysis patients. Methods: cross-sectional study with 123 patients on hemodialysis in Samuel Libânio Hospital – Pouso Alegre, MG, divided according to the economic class, into 3 groups: AB (n = 23), C (n = 60) and DE (n = 40). Were collected socio-demographic and economic data, clinical background and information about access to health services. For analysis of the results has been used statistical analytical and descriptive. We take p £ 0,05.  Results: The AB group has fewer young patients (4,3% in AB vs 40% in C and 25% in DE, p< 0,05), a greater number of individuals with more years of schooling (65,3% in AB vs 18,3% in C and 2,5% in DE; p< 0,05), predominance of patients with less than a year on haemodialysis treatment (65,2% in AB vs 10% in C and 5% in DE, p< 0,05), smaller number of users of SUS (40% in C and 25% in DE vs 4,3% in AB; p< 0,05), greater access to treatment with nephrologist (73,9% in AB vs 46,7% in C and 52,5% in DE; p< 0,05). Conclusion: Economically disadvantaged classes bring younger patients, with less schooling, users of SUS, patients with greater time on hemodialysis and worse access to treatment with nephrologist. 

scholarly journals Associations between multimorbidity and glycaemia (HbA1c) in people with type 2 diabetes: cross-sectional study in Australian general practice

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e039625
Author(s):  
Jason I Chiang ◽  
John Furler ◽  
Frances Mair ◽  
Bhautesh D Jani ◽  
Barbara I Nicholl ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
General Practice ◽  
Cross Sectional Study ◽  
Secondary Outcome ◽  
Linear Regression Models ◽  
Sectional Study ◽  
Cross Sectional ◽  
Long Term Conditions ◽  
Australian General Practice

ObjectivesTo explore the prevalence of multimorbidity as well as individual and combinations of long-term conditions (LTCs) in people with type 2 diabetes (T2D) attending Australian general practice, using electronic health record (EHR) data. We also examine the association between multimorbidity condition count (total/concordant(T2D related)/discordant(unrelated)) and glycaemia (glycated haemoglobin, HbA1c).DesignCross-sectional study.SettingAustralian general practice.Participants69 718 people with T2D with a general practice encounter between 2013 and 2015 captured in the MedicineInsight database (EHR Data from 557 general practices and >3.8 million Australian patients).Primary and secondary outcome measuresPrevalence of multimorbidity, individual and combinations of LTCs. Multivariable linear regression models used to examine associations between multimorbidity counts and HbA1c (%).ResultsMean (SD) age 66.42 (12.70) years, 46.1% female and mean (SD) HbA1c 7.1 (1.4)%. More than 90% of participants with T2D were living with multimorbidity. Discordant conditions were more prevalent (83.4%) than concordant conditions (69.9 %). The three most prevalent discordant conditions were: painful conditions (55.4%), dyspepsia (31.6%) and depression (22.8%). The three most prevalent concordant conditions were hypertension (61.4%), coronary heart disease (17.1%) and chronic kidney disease (8.5%). The three most common combinations of conditions were: painful conditions and hypertension (38.8%), painful conditions and dyspepsia (23.1%) and hypertension and dyspepsia (22.7%). We found no associations between any multimorbidity counts (total, concordant and discordant) or combinations and HbA1c.ConclusionsMultimorbidity was common in our cohort of people with T2D attending Australian general practice, but was not associated with glycaemia. Although we did not explore mortality in this study, our results suggest that the increased mortality in those with multimorbidity and T2D observed in other studies may not be linked to glycaemia. Interestingly, discordant conditions were more prevalent than concordant conditions with painful conditions being the second most common comorbidity. Better understanding of the implications of different patterns of multimorbidity in people with T2D will allow more effective tailored care.

scholarly journals How do delirium motor subtypes differ in phenomenology and contributory aetiology? a cross-sectional, multisite study of liaison psychiatry and palliative care patients

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e041214
Author(s):  
Kevin Glynn ◽  
Frank McKenna ◽  
Kevin Lally ◽  
Muireann O’Donnell ◽  
Sandeep Grover ◽  
...  
Keyword(s):  
Palliative Care ◽  
Rating Scale ◽  
Symptom Burden ◽  
Systemic Infection ◽  
International Study ◽  
Cross Sectional Study ◽  
Secondary Outcome ◽  
Liaison Psychiatry ◽  
Cross Sectional ◽  
Hypoactive Delirium

ObjectivesTo investigate whether delirium motor subtypes differ in terms of phenomenology and contributory aetiology.DesignCross-sectional study.SettingInternational study incorporating data from Ireland and India across palliative care, old age liaison psychiatry and general adult liaison psychiatry settings.Participants1757 patients diagnosed with delirium using criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fourth edition (DSM IV).Primary and secondary outcome measuresHyperactive, mixed and hypoactive delirium subtypes were identified using the abbreviated version of the Delirium Motor Subtype Scale. Phenomenology was assessed using the Delirium Rating Scale Revised. Contributory aetiologies were assessed using the Delirium Aetiology Checklist (DEC), with a score >2 indicating that the aetiology was likely or definitely contributory.ResultsHypoactive delirium was associated with dementia, cerebrovascular and systemic infection aetiologies (p<0.001) and had a lower overall burden of delirium symptoms than the other motor subtypes. Hyperactive delirium was associated with younger age, drug withdrawal and the DEC category other systemic aetiologies (p<0.001). Mixed delirium showed the greatest symptom burden and was more often associated with drug intoxication and metabolic disturbance (p<0.001). All three delirium motor subtypes had similar levels of impairment in attention and visuospatial functioning but differed significantly when compared with no subtype (p<0.001).ConclusionsThis study indicates a pattern of aetiology and symptomatology of delirium motor subtypes across a large international sample that had previously been lacking. It serves to improve our understanding of this complex condition and has implications in terms of early detection and management of delirium.

scholarly journals Frequent neurocognitive deficits after recovery from mild COVID-19

2020 ◽  
Vol 2 (2) ◽  
Author(s):  
Marcel S Woo ◽  
Jakob Malsy ◽  
Jana Pöttgen ◽  
Susan Seddiq Zai ◽  
Friederike Ufer ◽  
...  
Keyword(s):  
Short Term Memory ◽  
Telephone Interview ◽  
Acute Infection ◽  
Young Patients ◽  
Cross Sectional Study ◽  
Cognitive Status ◽  
Neurocognitive Deficits ◽  
Cross Sectional ◽  
Neuropsychiatric Complications ◽  
Moderate Disease

Abstract Neuropsychiatric complications associated with coronavirus disease 2019 caused by the Coronavirus SARS-CoV-2 (COVID-19) are increasingly appreciated. While most studies have focussed on severely affected individuals during acute infection, it remains unclear whether mild COVID-19 results in neurocognitive deficits in young patients. Here, we established a screening approach to detect cognitive deficiencies in post-COVID-19 patients. In this cross-sectional study, we recruited 18 mostly young patients 20–105 days (median, 85 days) after recovery from mild to moderate disease who visited our outpatient clinic for post-COVID-19 care. Notably, 14 (78%) patients reported sustained mild cognitive deficits and performed worse in the Modified Telephone Interview for Cognitive Status screening test for mild cognitive impairment compared to 10 age-matched healthy controls. While short-term memory, attention and concentration were particularly affected by COVID-19, screening results did not correlate with hospitalization, treatment, viremia or acute inflammation. Additionally, Modified Telephone Interview for Cognitive Status scores did not correlate with depressed mood or fatigue. In two severely affected patients, we excluded structural or other inflammatory causes by magnetic resonance imaging, serum and cerebrospinal fluid analyses. Together, our results demonstrate that sustained sub-clinical cognitive impairments might be a common complication after recovery from COVID-19 in young adults, regardless of clinical course that were unmasked by our diagnostic approach.

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