Current Issue : October - December Volume : 2018 Issue Number : 4 Articles : 5 Articles
Background: Primary care physicians in Japan see many patients in a given\nday; consequently, they find it challenging to devote sufficient time for detailed\nclinical consultation and evaluation of asthma control status. The aim of\nthis study was to investigate asthma symptoms that reveal the presence of inadequately\ncontrolled asthma. Methods: A pooled analysis of baseline data\nfrom 100 patients with asthma treated with inhaled corticosteroid(s) (ICS)\nalone or ICS/long-acting beta-agonist who participated in three previous clinical\ntrials was performed. Asthma control status and asthmatic symptoms\nwere determined using a five-item Asthma Control Questionnaire, and\nwhether asthmatic symptoms reflect clinical markers was investigated. Results:\nNocturnal awakening owing to asthmatic symptoms was observed only\nin the uncontrolled asthma group. Patient-reported wheezing was not observed\nin the group with well-controlled asthma, but was observed in all patients\nin the uncontrolled asthma group. Virtually all patients, irrespective of\nasthma control status, reported symptoms in the morning, limitation of normal\ndaily activities, and shortness of breath. Conclusions: The presence of\nnocturnal awakening due to asthma and wheezing likely reflected uncontrolled\nasthma. These results will lead to re-recognition that clinical interview,\nquerying nocturnal awakening from asthma and wheezing is a simple and\nuseful approach to assess asthma control status in a primary care setting....
OBJECTIVES: To determine the epidemiological features of pulmonary tuberculosis\nin the region of Gharb-Chrarda-Beni-Hssen in Morocco. METHODS:\nThis is a retrospective study of pulmonary tuberculosis cases, diagnosed and\ntreated at the regional diagnostic center of tuberculosis and respiratory diseases\n(RDCTRD) in Kenitra between January 2010 and December 2011. RESULTS:\nDuring the study period, there were 456 cases diagnosed with pulmonary tuberculosis\nat the RDCTRD, accounting for 51.3% of all tuberculosis cases reported\nduring this period. More than two-thirds were men (69%), with a\nmale-female ratio of 2.22 and 3.3% of cases were children under the age of 15\nyears. The average age of the patients was 37.07 �± 0.78 years. The average\nbody weight at diagnosis of tuberculosis was 56.20 �± 0.55 kg for all patients.\nAccording to the results, 89% of pulmonary tuberculosis cases were microscopically\npositive. The majority of patients (80.3%) showed signs of tuberculous\nimpregnation. Nearly three-quarters of these cases (71%) were smokers,\n21% were cannabis addicts and 7% were alcoholics. Among the 427 cases\nfor whom the outcome was known, 3 (0.7%) of them died. CONCLUSION:\nTuberculosis can be controlled by preventing transmission and infection, by\nstopping the progression from latent infection to active tuberculosis, and by\ntreating active disease....
Background. Neuromuscular blockade is a risk factor for postoperative respiratory weakness during the immediate postoperative\nperiod. The quantitative relationships between postoperative pulmonary-function impairment and residual neuromuscular\nblockade are unknown. Methods. 113 patients who underwent elective laparoscopic cholecystectomy were enrolled in this study.\nThey all had a pulmonary-function test (PFT) during the preoperative evaluation. Predictive values based on demographic data\nwere also recorded. The train-of-four ratio (TOFR) was recorded at the same time as the PFT and at every 5 minutes in the\nqualified 98 patients in the postanesthesia care unit (PACU). We analyzed the degree of PFT recovery when the TOFR had\nrecovered to different degrees. Results.There was a significant difference (...
A 49-year-old man had an abnormal shadow on chest X-ray. Enhanced chest\ncomputed tomography (CT) revealed an 8-cm diameter right lung mass invading\nthe right chest wall, with a tumor thrombus extending from the superior\npulmonary vein into the left atrium. Transesophageal echocardiography\nconfirmed that the tumor adjoined the side wall of the atrium. Endobronchial\nand CT-guided needle biopsy demonstrated a low-grade carcinoma or small\ncell carcinoma. Operative findings through left atriotomy under cardiopulmonary\nbypass showed no tumor invasion of the atrium wall, but protrusion\nthrough the pulmonary vein. Frozen sections revealed a non-small cell carcinoma.\nWe performed right upper lobectomy with parietal pleura and mediastinal\nlymph node dissection after detachment of cardiopulmonary bypass.\nPathological examination demonstrated a large-cell neuroendocrine carcinoma\np-T4N0M0, stage IIIA. The patient recovered without postoperative complications\nand tolerated two cycles of adjuvant chemotherapy. He was doing\nwell without symptoms of recurrence 42 months after surgery....
SETTING: Dar es Salaam, Tanzania. OBJECTIVE: To determine the prevalence\nof latent tuberculosis (TB) infection (LTBI) among adolescents in a\ncountry with a high TB burden, and examine risks of LTBI according to their\nsocial activity patterns. METHODS: A cross-sectional study nested within a\nphase 2b randomised, placebo controlled, double blind study and consisted of\n824 adolescents, 13 - 15 years old who had received Bacillus Calmette-Gu�©rin\n(BCG) vaccine, were attending public secondary schools and had no evidence\nof active tuberculosis (TB). Anthropometric measurements were obtained, a\nquestionnaire administered, and phlebotomy performed for a T spot interferon-\n�³ release assay (IGRA) to detect LTBI. RESULTS: Among 824 subjects,\n149 (18%) had a positive IGRA. After adjusting for the influence of household\nsocioeconomic status, history of TB contact, living environment and nutritional\nstatus, LTBI risk was higher in subjects with than without regular informal\nencounters with traditional alcoholic beverage drinkers (AOR, 6.37\n[1.84 - 22.00]). Other significant factors for LTBI risk included contact with\nTB patient at school (AOR, 3.34 [1.14 - 9.80]), and living close to a health facility,\nas was observed among those from houses within a 10 - 30-minute\nwalking distance to the nearest health facility, who were less likely to be\nIGRA-positive than those who were living within a 10-minute walking dis-tance (AOR, 0.30 [95%CI, 0.13 - 0.69]). CONCLUSION: This IGRA study\nrevealed a high prevalence of LTBI among adolescents in Dar es Salaam, Tanzania\nwith prior BCG immunization. Informal social encounters were identified\nas independent risk factors for LTBI, along with a history of contact with\nTB patients, living environment characteristics and household socioeconomic\nstatus. Efforts focusing on risk of MTB transmission in adolescents at informal\nsocial gatherings will improve interventions to reduce LTBI in this population\nand consequently the subsequent risk of developing active TB disease....
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