• 제목/요약/키워드: Respiratory Assessment

검색결과 394건 처리시간 0.027초

Oscillometry-Defined Small Airway Dysfunction in Patients with Chronic Obstructive Pulmonary Disease

  • Amit K. Rath;Dibakar Sahu;Sajal De
    • Tuberculosis and Respiratory Diseases
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    • 제87권2호
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    • pp.165-175
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    • 2024
  • Background: The prevalence of small airway dysfunction (SAD) in patients with chronic obstructive pulmonary disease (COPD) across different ethnicities is poorly understood. This study aimed to estimate the prevalence of SAD in stable COPD patients. Methods: We conducted a cross-sectional study of 196 consecutive stable COPD patients. We measured pre- and post-bronchodilator (BD) lung function and respiratory impedance. The severity of COPD and lung function abnormalities was graded in accordance with the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines. SAD was defined as either difference in whole-breath resistance at 5 and 19 Hz > upper limit of normal or respiratory system reactance at 5 Hz < lower limit of normal. Results: The cohort consisted of 95.9% men, with an average age of 66.3 years. The mean forced expiratory volume 1 second (FEV1) % predicted was 56.4%. The median COPD assessment test (CAT) scores were 14. The prevalence of post-BD SAD across the GOLD grades 1 to 4 was 14.3%, 51.1%, 91%, and 100%, respectively. The post-BD SAD and expiratory flow limitation at tidal breath (EFLT) were present in 62.8% (95% confidence interval [CI], 56.1 to 69.9) and 28.1% (95% CI, 21.9 to 34.2), respectively. COPD patients with SAD had higher CAT scores (15.5 vs. 12.8, p<0.01); poor lung function (FEV1% predicted 46.6% vs. 72.8%, p<0.01); lower diffusion capacity for CO (4.8 mmol/min/kPa vs. 5.6 mmol/min/kPa, p<0.01); hyperinflation (ratio of residual volume to total lung capacity % predicted: 159.7% vs. 129%, p<0.01), and shorter 6-minute walk distance (367.5 m vs. 390 m, p=0.02). Conclusion: SAD is present across all severities of COPD. The prevalence of SAD increases with disease severity. SAD is associated with poor lung function and higher symptom burden. Severe SAD is indicated by the presence of EFLT.

PM2.5 in poultry houses synergizes with Pseudomonas aeruginosa to aggravate lung inflammation in mice through the NF-κB pathway

  • Li, Meng;Wei, Xiuli;Li, Youzhi;Feng, Tao;Jiang, Linlin;Zhu, Hongwei;Yu, Xin;Tang, Jinxiu;Chen, Guozhong;Zhang, Jianlong;Zhang, Xingxiao
    • Journal of Veterinary Science
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    • 제21권3호
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    • pp.46.1-46.18
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    • 2020
  • Background: High concentrations of particulate matter less than 2.5 ㎛ in diameter (PM2.5) in poultry houses is an important cause of respiratory disease in animals and humans. Pseudomonas aeruginosa is an opportunistic pathogen that can induce severe respiratory disease in animals under stress or with abnormal immune functions. When excessively high concentrations of PM2.5 in poultry houses damage the respiratory system and impair host immunity, secondary infections with P. aeruginosa can occur and produce a more intense inflammatory response, resulting in more severe lung injury. Objectives: In this study, we focused on the synergistic induction of inflammatory injury in the respiratory system and the related molecular mechanisms induced by PM2.5 and P. aeruginosa in poultry houses. Methods: High-throughput 16S rDNA sequence analysis was used for characterizing the bacterial diversity and relative abundance of the PM2.5 samples, and the effects of PM2.5 and P. aeruginosa stimulation on inflammation were detected by in vitro and in vivo. Results: Sequencing results indicated that the PM2.5 in poultry houses contained a high abundance of potentially pathogenic genera, such as Pseudomonas (2.94%). The lung tissues of mice had more significant pathological damage when co-stimulated by PM2.5 and P. aeruginosa, and it can increase the expression levels of interleukin (IL)-6, IL-8, and tumor necrosis factor-α through nuclear factor (NF)-κB pathway in vivo and in vitro. Conclusions: The results confirmed that poultry house PM2.5 in combination with P. aeruginosa could aggravate the inflammatory response and cause more severe respiratory system injuries through a process closely related to the activation of the NF-κB pathway.

Perceived Competency, Frequency, Training Needs in Physical Assessment among Registered Nurses

  • Oh, Heeyoung;Lee, Jiyeon;Kim, Eun Kyung
    • 성인간호학회지
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    • 제24권6호
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    • pp.627-634
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    • 2012
  • Purpose: The purpose of this study was to identify registered nurses learning needs about physical assessment. Specifically, what are the perceived competency, frequency of skill use and the unmet training needs. Methods: The study was an exploratory survey study. The sample was 104 registered nurses. Data were collected through three instruments: The Perceived Competency in Physical Assessment Scale, the Frequency of Physical Assessment Scale, and the Training Needs of Physical Assessment Scale which incorporated 30 core Physical Assessment skills. Descriptive statistics, t-test, and Pearson's correlation coefficient were used to analyze the data. Results: Auscultation of heart and lung sounds and inspection of the spine were rated by the subjects as physical assessment skills they feel least competent and also were less frequently performed. The most competent area for physical assessment was neurological system. The respiratory and abdominal system was identified as two systems that more education would be needed. Nurses with less than one year of working experience reported needing more training. Nurses with more than five years of clinical work experience performed physical assessment more frequently than nurses with less than five year of work experience. The perceived competency was positively related to the frequency of physical assessment. Conclusion: Continuing education is necessary to further train registered nurses regarding physical assessment skills and the program needs to be focused on the area which nurses are less competent for and have high training need.

Comparative evaluation of ultrasonography with clinical respiratory score in diagnosis and prognosis of respiratory diseases in weaned dairy buffalo and cattle calves

  • Hussein, Hussein Awad;Binici, Cagri;Staufenbiel, Rudolf
    • Journal of Animal Science and Technology
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    • 제60권12호
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    • pp.29.1-29.11
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    • 2018
  • Background: Respiratory troubles have economic impacts in countries where livestock industry is an important segment of the agricultural sector, as well as these problems may cause significant economic losses for bovine producers. Various practical methods are used to assess diseases that affect the bovine respiratory system. Ultrasonography is a noninvasive tool that has been used frequently in diagnosis of various animal diseases. The present study was designed to establish whether thoracic ultrasonography is a diagnostic tool for detection of respiratory troubles in weaned buffalo and cattle calves, as well as to assess its prognostic value in comparison with clinical respiratory scores. Thirty five (15 buffalo and 20 cattle) calves were included. Twelve (6 buffalo and 6 cattle) clinically healthy calves were enrolled as controls. Results: Based on physical examinations, clinical respiratory scores (CRS), ultrasound lung scores (ULS) and postmortem findings, animals were classified into 4 groups as pulmonary emphysema (n = 8), interstitial pulmonary syndrome (n = 7), bronchopneumonia (n = 12), and pleurisy (n = 8). The mean values of CRS and ULS were significantly higher in diseased calves (P < 0.01). In calves with pulmonary emphysema and interstitial syndrome, thoracic ultrasonography revealed numerous comet-tail artifacts, which varied in numbers and imaging features. Furthermore, variable degrees of pulmonary consolidation with alveolograms and bronchograms were noticed in bronchopneumonic calves. In addition, thick irregular or fragmented pleura with pleural effusions and fibrin shreds were imaged in calves with pleurisy. A weak correlation was calculated between CRS and ULS (r = 0.55, P < 0.01). Hematologically, the counts of white blood cells, activities of aspartate aminotransferase and partial tensions of carbon dioxide were significantly increased in all diseased groups. Serum concentrations of total globulins were higher in claves with bronchopneumonia (P < 0.05). The partial tension of oxygen was decreased in all diseased calves (P < 0.05). Conclusions: Thoracic ultrasonography is a diagnostic tool for various lung troubles and assessment the grade and severity of pulmonary diseases, as well as it can be used as a follow-up tool for evaluating the prognosis of respiratory troubles and monitoring the efficacy of therapies.

경피신경전기자극과 호흡근 저항운동 동시 적용이 만성 뇌졸중 환자의 호흡근 근긴장도와 폐 기능에 미치는 영향 (The Effect of the Resistance Respiratory Muscle Exercise with Transcutaneous Electrical Nerve Stimulation on Respiratory Muscle Tone and Pulmonary Function of Chronic Stroke Patients)

  • 조용훈;조균희
    • 대한물리의학회지
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    • 제17권1호
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    • pp.75-83
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    • 2022
  • PURPOSE: This study was conducted to investigate the effect of the resistance respiratory muscle exercise with transcutaneous electrical nerve stimulation (TENS) on the respiratory muscle tone and pulmonary function of stroke patients. METHODS: Twenty stroke patients were divided into the TENS group (n = 7), placebo TENS group (n = 7), and control group (n = 6), and each intervention was performed on the three groups 5 times a week for 4 weeks. The assessment was carried out by measuring changes in the muscle tone of the latissimus dorsi and abdominal external obliques, and pulmonary function. RESULTS: In this study, the TENS group and the placebo TENS group had significant increases in the paretic side latissimus dorsi muscle tone, forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), and peak expiratory flow (PEF). There was no significant difference in changes in respiratory muscle tone between the three groups. The pulmonary function was significantly different between the three groups, and it was observed from the results of the post-hoc test that FVC showed a significant increase in the TENS group and the placebo TENS group compared to the control group. CONCLUSION: Through this study, it was found that the respiratory muscle resistance exercise was more effective as a method to increase respiratory muscle tone and pulmonary function in stroke patients than combined transcutaneous electrical nerve stimulation.

Association between Inhaled Corticosteroid Use and SARS-CoV-2 Infection: A Nationwide Population-Based Study in South Korea

  • Lee, Sang Chul;Son, Kang Ju;Han, Chang Hoon;Jung, Ji Ye;Park, Seon Cheol
    • Tuberculosis and Respiratory Diseases
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    • 제85권1호
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    • pp.80-88
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    • 2022
  • Background: Although it is known that inhaled corticosteroid (ICS) use may increase the risk of respiratory infection, its influence on the risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection remains unknown. Thus, the aim of this study was to investigate the association between ICS use and the positivity of SARS-CoV-2 infection among patients with chronic respiratory diseases. Methods: Nationwide data of 44,968 individuals with chronic respiratory diseases tested for SARS-CoV-2 until May 15, 2021 were obtained from the Ministry of Health and Welfare and Health Insurance Review and Assessment Service in Korea. The positivity of SARS-CoV-2 infection was retrospectively analysed according to the prescription, type, and dose of ICS taken one year before SARS-CoV-2 test. Results: Among 44,968 individuals tested, 931 (2.1%) were positive for SARS-CoV-2. A total of 7,019 patients (15.6%) were prescribed ICS one year prior to being tested for SARS-CoV-2. Low, medium, and high doses of ICS were prescribed in 7.5%, 1.6%, and 6.5% of total cases, respectively. Among types of ICS, budesonide, fluticasone, beclomethasone, and ciclesonide were prescribed in 3.7%, 8.9%, 2.3%, and 0.6% of total cases, respectively. A multivariate analysis showed no significant increase in infection with ICS use (odds ratio, 0.84; 95% confidence interval, 0.66-1.03). Moreover, there were no associations between the positivity of infection and the dose or type of ICS prescribed. Conclusion: Prior ICS use did not increase the positivity for SARS-CoV-2 infection. Moreover, different doses or types of ICS did not affect this positivity.

Does the Use of Asthma-Controller Medication in Accordance with Guidelines Reduce the Incidence of Acute Exacerbations and Healthcare Costs?

  • Lee, Suh-Young;Kim, Kyungjoo;Park, Yong Bum;Yoo, Kwang Ha
    • Tuberculosis and Respiratory Diseases
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    • 제85권1호
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    • pp.11-17
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    • 2022
  • Background: In asthma, consistent control of chronic airway inflammation is crucial, and the use of asthma-controller medication has been emphasized. Our purpose in this study is to compare the incidence of acute exacerbation and healthcare costs related to the use of asthma-controller medication. Methods: By using data collected by the National Health Insurance Review and Assessment Service, we compared one-year clinical outcomes and medical costs from July 2014 to June 2015 (follow-up period) between two groups of patients with asthma who received different prescriptions for recommended asthma-controller medication (inhaled corticosteroids or leukotriene receptor antagonists) at least once from July 2013 to June 2014 (assessment period). Results: There were 51,757 patients who satisfied our inclusion criteria. Among them, 13,702 patients (26.5%) were prescribed a recommended asthma-controller medication during the assessment period. In patients using a recommended asthma-controller medication, the frequency of acute exacerbations decreased in the follow-up period, from 2.7% to 1.1%. The total medical costs of the controller group decreased during the follow-up period compared to the assessment period, from $3,772,692 to $1,985,475. Only 50.9% of patients in the controller group used healthcare services in the follow-up period, and the use of asthma-controller medication decreased in the follow-up period. Conclusion: Overall, patients using a recommended asthma-controller medication showed decreased acute exacerbation and reduced total healthcare cost by half.

대한한의학회지 및 대한한의학회 산하 정회원 학회의 학술진흥재단 등재지에 대한 비염 임상연구의 체계적 고찰 (A Systematic Review from the Journals under the Korean Oriental Medical Society)

  • 이규선;박동희;김계은;방지현;김재환;최준용;정희재;정승기
    • 대한한의학회지
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    • 제31권5호
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    • pp.1-11
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    • 2010
  • Objectives: This study aimed to evaluate any clinical studies regarding rhinitis published by the Korean Oriental Medical Society and its sub-societies for future rigorous clinical research. Methods: Every article relevant to rhinitis was initially obtained from journals of the Korean Oriental Medical Society and its sub-societies by electronic search at journal web sites or manual searches. Journals were limited to those registered with the Korea Research Foundation. From initial findings, two independent reviewers selected clinical articles and these articles were further analyzed separately by predefined criteria according to prospective and retrospective studies. For prospective studies, quality assessment was also conducted. Results: From 36 initially obtained articles, 17 were finally analyzed. 2 articles were randomized controlled studies, 6 articles were prospective whereas 9 were retrospective. In the prospective articles, there were no randomized controlled trials and the other non-randomized studies had no control group with several problems of quality regarding pre-calculated study size and unbiased assessment. None of the retrospective studies described rhinitis diagnosis objectively and outcome measures were either non-relevant to rhinitis or non-validated. Conclusions: Further well-designed randomized controlled studies for rhinitis are mandatory and more rigorous non-randomized controlled studies should be conducted.

세종시 건설현장 인근 주민의 알레르기 및 호흡기 질환 유병 실태: 혼합연구방법론을 적용한 탐색적 연구 (Prevalence of allergic and respiratory conditions among residents living near large construction sites in Sejong city: an exploratory study with mixed method approach)

  • 기명;신지연;김라희;조성식;안아름;김영주
    • 농촌의학ㆍ지역보건
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    • 제40권2호
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    • pp.80-92
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    • 2015
  • 건설현장 주변지역 주민의 호흡기 증상과 질환 유병률은 대조지역에 비해 높았다. 양적인 결과는 지역의 노출과 질환 상황에 대한 질적인 탐색에 의해 뒷받침되었다. 이는 건설현장 주변 분진이 지역 주민들의 호흡기 관련 증상 및 질환에 영향이 미쳤을 가능성을 시사하는 것이다. 향후 본 연구의 탐색적 결과를 토대로 알레르기 및 호흡기 질환에 대한 추가 조사가 필요하며, 미세먼지 저감 등 환경관리 노력이 강화되어야 할 것이다.

국외 감염병 위험도 평가체계의 비교분석 (Comparative Analysis of Risk Assessment Tools for Infectious Diseases)

  • 최은미;우다래;최영준;예정용;박상신
    • 보건행정학회지
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    • 제32권4호
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    • pp.380-388
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    • 2022
  • Background: Emerging infectious diseases, such as Middle East respiratory syndrome or coronavirus disease 2019, pose a continuous threat to public health, making a risk assessment necessary for infectious disease control and prevention. Therefore, we aimed to investigate the risk assessment methods for infectious diseases used by major foreign countries and organizations. Methods: We conducted an investigation and comparative analysis of risk assessment and risk determination methods for infectious diseases. The risk assessment tools included the strategic toolkit for assessing risks, influenza risk assessment tool, pandemic severity assessment framework, and rapid risk assessment methodology. Results: The most frequently reported risk elements were disease severity, antiviral treatment, attack rate, population immunity, and basic productive ratio. The risk evaluation method was evaluated quantitatively and qualitatively by the stakeholders at each institution. Additionally, the final risk level was visualized in a matrix, framework, and x and y-axis. Conclusion: Considering the risk assessment tools, the risk element was classified based on the duplicate of each indicator, and risk evaluation and level of risk assessment were analyzed.