Respiratory Disease Research Papers - Academia.edu (original) (raw)

Nevertheless, it could be stated that dampness and moulds are cases of pollution sources that could, in theory, be totally removed. This would enable the elimination of those sources and effects by the use of a source control strategy. In... more

Nevertheless, it could be stated that dampness and moulds are cases of pollution sources that could, in theory, be totally removed. This would enable the elimination of those sources and effects by the use of a source control strategy. In fact, if the control of a few physical parameters could be guaranteed, the occurrence of dampness and moulds would be

The influence of the mode of anaesthesia on outcome of geriatric patients with hip fractures is a controversial issue in the medical literature. In the light of an ageing society, a conclusive answer to this question is of growing... more

The influence of the mode of anaesthesia on outcome of geriatric patients with hip fractures is a controversial issue in the medical literature. In the light of an ageing society, a conclusive answer to this question is of growing importance. The purpose of this review was to assess the effect of neuroaxial and general anaesthesia on mortality and morbidity in geriatric patients sustaining a hip fracture. Following a current literature search within the Pubmed and Cochrane database (1967–2010), 34 randomised controlled trials, 14 observational studies and eight reviews/meta-analysis publications were included. Potentially outcome-influencing factors such as mortality, deep vein thrombosis, pulmonary embolism, postoperative confusion and other anaesthesia-related outcomes were evaluated. After analysing the current literature with 56 references, covering 18,715 patients with hip fracture, it can be concluded that spinal anaesthesia is associated with significantly reduced early mortality, fewer incidents of deep vein thrombosis, less acute postoperative confusion, a tendency to fewer myocardial infarctions, fewer cases of pneumonia, fatal pulmonary embolism and postoperative hypoxia. General anaesthesia has the advantages of having a lower incidence of hypotension and a tendency towards fewer cerebrovascular accidents compared to neuroaxial anaesthesia. Otherwise, general anaesthesia and respiratory diseases were significant predictors of morbidity in hip fracture patients. These data suggest that regional anaesthesia is the preferred technique, but the limited evidence available does not permit a definitive conclusion to be drawn for mortality or other outcomes. For hip fracture surgery, the choice of anaesthesia (general or neuroaxial) is made by the anaesthesiologist and is based on the patient’s preference, comorbidities, potential general postoperative complications and the clinical experience of the anaesthesiologist. The overall therapeutic approach in hip fracture care should be determined jointly by the orthopaedic surgeon, the geriatrician and the anaesthesiologist (multidisciplinary approach).

Background Air pollution in Darwin, Northern Australia, is dominated by smoke from seasonal fires in the surrounding savanna that burn during the dry season from April to November. Our aim was to study the association between particulate... more

Background Air pollution in Darwin, Northern Australia, is dominated by smoke from seasonal fires in the surrounding savanna that burn during the dry season from April to November. Our aim was to study the association between particulate matter less than or equal to 10 microns diameter (PM10) and daily emergency hospital admissions for cardio-respiratory diseases for each fire season from 1996 to 2005. We also investigated whether the relationship differed in indigenous Australians; a disadvantaged population sub-group. Methods Daily PM10 exposure levels were estimated for the population of the city from visibility data using a previously validated model. We used over-dispersed Poisson generalized linear models with parametric smoothing functions for time and meteorology to examine the association between admissions and PM10 up to three days prior. An interaction between indigenous status and PM10 was included to examine differences in the impact on indigenous people. Results We found both positive and negative associations and our estimates had wide confidence intervals. There were generally positive associations between respiratory disease and PM10 but not with cardiovascular disease. An increase of 10 μg/m3 in same-day estimated ambient PM10 was associated with a 4.81% (95%CI: -1.04%, 11.01%) increase in total respiratory admissions. When the interaction between indigenous status and PM10 was assessed a statistically different association was found between PM10 and admissions three days later for respiratory infections of indigenous people (15.02%; 95%CI: 3.73%, 27.54%) than for non-indigenous people (0.67%; 95%CI: -7.55%, 9.61%). There were generally negative estimates for cardiovascular conditions. For non-indigenous admissions the estimated association with total cardiovascular admissions for same day ambient PM10 and admissions was -3.43% (95%CI: -9.00%, 2.49%) and the estimate for indigenous admissions was -3.78% (95%CI: -13.4%, 6.91%), although ambient PM10 did have positive (non-significant) associations with cardiovascular admissions of indigenous people two and three days later. Conclusion We observed positive associations between vegetation fire smoke and daily hospital admissions for respiratory diseases that were stronger in indigenous people. While this study was limited by the use of estimated rather than measured exposure data, the results are consistent with the currently small evidence base concerning this source of air pollution.

Non-allergic rhinitis (NAR) is a common disorder, which can be defined as chronic nasal inflammation, independent of systemic IgE-mediated mechanisms. Symptoms of NAR patients mimic those of allergic rhinitis (AR) patients. However, AR... more

Non-allergic rhinitis (NAR) is a common disorder, which can be defined as chronic nasal inflammation, independent of systemic IgE-mediated mechanisms. Symptoms of NAR patients mimic those of allergic rhinitis (AR) patients. However, AR patients can easily be diagnosed with skin prick test or allergen-specific IgE measurements in the serum, whereas NAR patients form a heterogeneous group and are difficult to diagnose because of an extensive list of different phenotypes, all varying in severity, underlying etiology and type of inflammation. Characterization of those phenotypes, mechanisms and management of NAR represents one of the major unmet needs in the field of allergic and non-allergic diseases. This review aims at providing a comprehensive overview of the state of the art in classifying the NAR patients and focuses on the neuro-immune mechanisms involved in allergic and non-allergic rhinitis, including reflections on the pathophysiology and the currently available treatment opti...

A respiratory health study of fly-in-fly-out workers potentially exposed to airborne contaminants, and a control group, was conducted at the Murrin-Murrin mine site in Western Australia. Lung function was measured in terms of validated... more

A respiratory health study of fly-in-fly-out workers potentially exposed to airborne contaminants, and a control group, was conducted at the Murrin-Murrin mine site in Western Australia. Lung function was measured in terms of validated protocols (American Thoracic Society, 1995; Miller et al., 2005). The effect of length of service, as well as work area/department on lung function was established. Repeat lung function tests were conducted after approximately two years, in order to measure decrements over time. Furthermore testing was conducted on a cohort of refinery workers, prior to commencement and upon completion of their work period on-site (swing), in order to detect if there were decrements in lung function over this period. No significant decrements were detected in any of the work areas. Length of service was not related to a decrease in lung function however, effects of smoking were detected in the cohort.

The European Position Paper on Rhinosinusitis and Nasal Polyps 2012 is the update of similar evidence based position papers published in 2005 and 2007. The document contains chapters on definitions and classification, we now also proposed... more

The European Position Paper on Rhinosinusitis and Nasal Polyps 2012 is the update of similar evidence based position papers published in 2005 and 2007. The document contains chapters on definitions and classification, we now also proposed definitions for difficult to treat rhinosinusitis, control of disease and better definitions for rhinosinusitis in children. More emphasis is placed on the diagnosis and treatment of acute rhinosinusitis. Throughout the document the terms chronic rhinosinusitis without nasal polyps (CRSsNP) and chronic rhinosinusitis with nasal polyps (CRSwNP) are used to further point out differences in pathophysiology and treatment of these two entities. There are extensive chapters on epidemiology and predisposing factors, inflammatory mechanisms, (differential) diagnosis of facial pain, genetics, cystic fibrosis, aspirin exacerbated respiratory disease, immunodeficiencies, allergic fungal rhinosinusitis and the relationship between upper and lower airways. The ...

Anxiety and Depression Short Scale: norms for its use in rehabilitatio n. L. Moroni, O. Bettinardi, G. Vidotto, G. Balestroni, G. Bruletti, I. Giorgi, G. Bertolotti. In the rehabilitation setting it is important to identify clinically... more

Anxiety and Depression Short Scale: norms for its use in rehabilitatio n. L. Moroni, O. Bettinardi, G. Vidotto, G. Balestroni, G. Bruletti, I. Giorgi, G. Bertolotti. In the rehabilitation setting it is important to identify clinically significant conditions of distress so as to be able to provide, in addition to the conventional multidisplinary re- habilitation treatment, specific psychotherapeutic interven- tions

Objective The aim of this case control study was to evaluate which cephalometric variables related to craniofacial morphology discriminate between snoring and non-snoring or any other respiratory disease subjects. Materials and Methods... more

Objective The aim of this case control study was to evaluate which cephalometric variables related to craniofacial morphology discriminate between snoring and non-snoring or any other respiratory disease subjects. Materials and Methods Total 42(21 snoring and 21 non-snoring) cephalometric measurements were determined to study the craniofacial morphology. Non-snoring subjects were matched to snoring subjects by age, sex, and body mass index. Snoring was assessed using a sleep behavior questionnaire administered to the patients. The cephalometric radiographs of the study subjects were traced by a single investigator, and 1 angular measurement and 13 linear measurements of hard and soft tissues were recorded. The paired Student’s t test was used to analyze the cephalometric data. Results Vertical position of the hyoid (MP-H) was significantly longer (P<0.05) in snoring subjects (23.44±14.892mm) than non-snoring subjects (12.89±4.540mm). Anterior overbite and anterior over-jet of snoring group ((4.81± 3.265 and 5.83±8.59) were significantly higher (P<0.05) than non-snoring group (0.67±1.441 and 0.54±1.138). No significant differences of the other [11] cephalometric variables were found within groups. Conclusion Snoring subjects appear to present craniofacial factors that differ from those of non-snoring subjects, and we suggest obtaining cephalogram for diagnosis and following up of them.

Chronic obstructive pulmonary disease (COPD) is a chronic disease causing increasing healthcare costs worldwide. Another respiratory disease causing high costs and morbidity is community-acquired pneumonia (CAP). Because of the constant... more

Chronic obstructive pulmonary disease (COPD) is a chronic disease causing increasing healthcare costs worldwide. Another respiratory disease causing high costs and morbidity is community-acquired pneumonia (CAP). Because of the constant growth in the population with both diseases (CAP and COPD), analyzing their clinical characteristics is important. Several cellular factors are known to contribute to differences in clinical expression: some lead to COPD exacerbations while others lead to symptoms of pneumonia. The use of new biomarkers (procalcitonin, pro-adrenomedullin and copeptin) help to distinguish among these clinical pictures. To decrease morbidity and mortality, clinical guidelines on antibiotic therapy must be followed and this therapy should be prescribed to patients with CAP and COPD. There are also prevention measures such as the pneumococcal vaccine whose role in the prevention of pneumococcal CAP should be further studied. The present review aims to elucidate some of the above-mentioned issues.