• Title/Summary/Keyword: Respiratory Assessment

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Chronic Obstructive Pulmonary Disease: Respiratory Review of 2013

  • Kim, Yu-Il
    • Tuberculosis and Respiratory Diseases
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    • v.76 no.2
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    • pp.53-58
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    • 2014
  • Chronic obstructive pulmonary disease (COPD) is a common airway disease that has considerable impact on disease burdens and mortality rates. A large number of articles on COPD are published within the last few years. Many aspects on COPD ranging from risk factors to management have continued to be fertile fields of investigation. This review summarizes 6 clinical articles with regards to the risk factors, phenotype, assessment, exacerbation, management and prognosis of patients with COPD which were being published last year in major medical journals.

Relationships between Respiratory Diseases and Safety of Pediatric Dental Sedation (소아의 호흡기 질환과 안전한 치과진정법의 연관성)

  • Chung, Woojin;Jeong, Taesung
    • Journal of the korean academy of Pediatric Dentistry
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    • v.42 no.4
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    • pp.327-330
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    • 2015
  • The safety and success of dental sedation for children depend mainly on respiratory status of patients. A special condition, that is, nasal breathing in supine position with their oral airway blocked by rubber dam, should be considered. Therefore, irrespective of medical consultation, pediatric dentists themselves should do respiratory assessment especially adenotonsillar hypertrophy, nasal obstruction, posterior nasal drainage and airway hypersensitivity. Patients with sinusitis, allergic rhinitis, asthma, snoring and OSAS(obstructive sleep apnea syndrome) can induce the sedation failure and complete management of these can improve the safety of dental sedation.

Risk Assessment for Metalworking Fluids and Respiratory Outcomes

  • Park, Robert M.
    • Safety and Health at Work
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    • v.10 no.4
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    • pp.428-436
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    • 2019
  • Background: Metalworking fluids (MWFs) are mixtures with inhalation exposures as mists, dusts, and vapors, and dermal exposure in the dispersed and bulk liquid phase. A quantitative risk assessment was performed for exposure to MWF and respiratory disease. Methods: Risks associated with MWF were derived from published studies and NIOSH Health Hazard Evaluations, and lifetime risks were calculated. The outcomes analyzed included adult onset asthma, hypersensitivity pneumonitis, pulmonary function impairment, and reported symptoms. Incidence rates were compiled or estimated, and annual proportional loss of respiratory capacity was derived from cross-sectional assessments. Results: A strong healthy worker survivor effect was present. New-onset asthma and hypersensitivity pneumonitis, at 0.1 mg/㎥ MWF under continuous outbreak conditions, had a lifetime risk of 45%; if the associated microbiological conditions occur with only 5% prevalence, then the lifetime risk would be about 3%. At 0.1 mg/㎥, the estimate of excess lifetime risk of attributable pulmonary impairment was 0.25%, which may have been underestimated by a factor of 5 or more by a strong healthy worker survivor effect. The symptom prevalence associated with respiratory impairment at 0.1 mg/㎥ MWF was estimated to be 5% (published studies) and 21% (Health Hazard Evaluations). Conclusion: Significant risks of impairment and chronic disease occurred at 0.1 mg/㎥ for MWFs in use mostly before 2000. Evolving MWFs contain new ingredients with uncharacterized long-term hazards.

Analysis of Correlation between Respiratory Characteristics and Physical Factors in Healthy Elementary School Childhood (학령기 정상 아동의 호흡 특성과 신체 조건에 관한 상관분석)

  • Lee, Hye Young;Kang, Dong Yeon;Kim, Kyoung
    • The Journal of Korean Physical Therapy
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    • v.25 no.5
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    • pp.330-336
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    • 2013
  • Purpose: Respiratory is an essential vital component for conservation of life in human, which is controlled by respiratory muscles and its related neuromuscular regulation. The purpose of this study is to assess lung capacity and respiratory pressure in healthy children, and to investigate relationship and predictability between respiratory pressure and other related respiratory functions. Methods: A total of 31 healthy children were recruited for this study. Demographic information and respiratory related factors were assessed in terms of body surface area (BSA), chest mobility, lung capacity, and respiratory pressure. Correlation between respiratory pressure and the rested variables was analyzed, and multiple regression using the stepwise method was performed for prediction of respiratory muscle strength, in terms of respiratory pressure as the dependent variable, and demographic and other respiratory variables as the independent variable. Results: According to the results of correlation analysis, respiratory pressure showed significant correlation with age (r=0.62, p<0.01), BSA (r=0.80, p<0.01), FVC (r=0.80, p<0.01), and FEV1 (r=0.70, p<0.01). In results of multiple regression analysis using the backward elimination method, BSA and FVC were included as significant factors of the predictable statistical model. The statistical model showed a significant explanation power of 71.8%. Conclusion: These findings suggest that respiratory pressure could be a valuable measurement tool for evaluation of respiratory function, because of significant relationship with physical characteristics and lung capacity, and that BSA and FVC could be possible predictable factors to explain the degree of respiratory pressure. These findings will provide useful information for clinical assessment and treatment in healthy children as well as those with pulmonary disease.

Prescription of Systemic Steroids for Acute Respiratory Infections in Korean Outpatient Settings: Overall Patterns and Effects of the Prescription Appropriateness Evaluation Policy

  • Kim, Taejae;Do, Young Kyung
    • Journal of Preventive Medicine and Public Health
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    • v.53 no.2
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    • pp.82-88
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    • 2020
  • Objectives: The objective of this study was to identify individual and institutional factors associated with the prescription of systemic steroids in patients with acute respiratory infections and to investigate the role of a policy measure aimed to reduce inappropriate prescriptions. Methods: We used data from the National Health Insurance Service-National Sample Cohort from 2006 to 2015 and focused on episodes of acute respiratory infection. Descriptive analysis and multiple logistic regression analysis were performed to identify individual-level and institution-level factors associated with the prescription of systemic steroids. In addition, steroid prescription rates were compared with antibiotic prescription rates to assess their serial trends in relation to Health Insurance Review and Assessment Service (HIRA) Prescription Appropriateness Evaluation policy. Results: Among a total of 9 460 552 episodes of respiratory infection, the steroid prescription rate was 6.8%. Defined daily doses/1000 persons/d of steroid increased gradually until 2009, but rose sharply since 2010. The steroid prescription rate was higher among ear, nose and throat specialties (13.0%) than other specialties, and in hospitals (8.0%) than in tertiary hospitals (3.0%) and other types of institutions. Following a prolonged reduction in the steroid prescription rate, this rate increased since the HIRA Prescription Appropriateness Evaluation dropped steroids from its list of evaluation items in 2009. Such a trend reversal was not observed for the prescription rate of antibiotics, which continue to be on the HIRA Prescription Appropriateness Evaluation list. Conclusions: Specialty and type of institution are important correlates of steroid prescriptions in cases of acute respiratory infection. Steroid prescriptions can also be influenced by policy measures, such as the HIRA Prescription Appropriateness Evaluation policy.

Pulmonary Fibrosis caused by Asbestos Fibers in the Respiratory Airway

  • Jung, Ji-Woo;Kim, Eung-Sam
    • Biomedical Science Letters
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    • v.27 no.3
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    • pp.111-120
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    • 2021
  • Asbestos products had been widely used until 2007 in Korea since the 1930s. A total ban on their production and applications has been imposed because of the toxic effect of asbestos fibers on the human health. The inhaled asbestos fibers increase reactive oxygen species and inflammatory reactions in the respiratory airway including the alveolar sac, resulting in DNA damages and secretion of several inflammatory cytokines or chemokines. These paracrine communications promote the proliferation of fibroblasts and the synthesis of collagen fibers, thereby depositing them into the extracellular matrix at the interstitial space of alveoli. The fibrotic tissue hindered the gas exchange in the alveolus. This reviews describes not only the cytotoxic effects of asbestos fibers with different physical or chemical characteristics but also the interaction of cells that make up the respiratory airway to understand the molecular or cellular mechanisms of asbestos fiber-induced toxicity. In addition, we propose a pulmonary toxicity research technique based on the mini-lung that can mimic human respiratory system as an alternative to overcome the limitations of the conventional risk assessment of asbestos fibers.

Clinical Research Trends of Gut Microbiome for Respiratory Diseases (호흡기질환에 대한 장내 미생물의 임상 연구 동향)

  • Lee, Su Won;Choi, Jin Kwan;Yang, Won Kyung;Kim, Seung Hyung;Lyu, Yee Ran;Park, Yang Chun
    • The Journal of Korean Medicine
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    • v.42 no.3
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    • pp.119-138
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    • 2021
  • Objectives: This study aimed to review the clinical research of the gut microbiome for respiratory diseases to assist the design of trials for respiratory diseases by regulating the gut microbiome with herbal medicine later. Methods: We searched three international databases (PubMed, CENTRAL and EMBASE) to investigate randomized controlled trials (RCTs) of the gut microbiome for respiratory diseases. The selected trials were analyzed by study design, subject diseases, inclusion/exclusion criteria, sample size, study period, intervention group, control group, outcome measures, and study results. Results: A total of 25 studies were included and published from 1994 to 2021 mostly in Europe and Asia. Subject diseases were many in the order of respiratory tract infection, cystic fibrosis, allergy, and so on. As outcome measures, the gut microbiome in a fecal sample was analyzed by 16S rRNA sequencing analysis method, and symptom assessment tools related each disease were used. Major intervention drugs were probiotics and the results were mostly improved in the composition and diversity of the gut microbiome. Conclusion: Clinical studies of the gut microbiome for respiratory diseases have confirmed various effects and this review provides basic data for a well-designed clinical study for respiratory diseases by regulating the gut microbiome with herbal medicine.

Prescription Characteristics of Medication for Acute Respiratory Diseases before and after Pay-for-Performance -using National Health Insurance Big data- (의원 가감지급사업 실시 전후에 따른 급성호흡기계질환의 의약품 처방특성 -국민건강보험 빅데이터를 활용하여-)

  • Gong, Mi-Jin;Hwang, Byung-Deog
    • The Korean Journal of Health Service Management
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    • v.14 no.1
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    • pp.93-102
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    • 2020
  • Objectives: This study analyzed the prescription characteristics of medication for acute respiratory diseases before and after pay-for-performance to provide basic data on effective medical quality management policies. Methods: The research data were collected from the 2013-2014 sample cohort of the National Health Insurance Corporation, from Internal Medicine, Pediatrics, Otorhinolaryngology, Family Medicine and General practitioner clinics (classification of disease codes: J00-J06, J20-J22, J40 outpatients). Results: The antibiotics prescription rates decreased from 43.9% in 2013 to 43.5% in 2014 when the major diagnosis was for upper respiratory infections and increased from 62.0% in 2013 to 62.5% in 2014 when the major diagnosis was for lower respiratory infections. Conclusions: There is a need to identify the correct antibiotic prescription method by expanding the current assessment standards. Such standards must include acute lower respiratory infections and minor diagnoses as the current evaluation techniques focus only on the major diagnosis of acute upper respiratory infections.