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Authors treated and checked 474 patients with acute myocardial infarction (AMI) during 5 years. The occurrence of hypertension was 37.15% of the total number of patients but this rate was 51.37% for women patients. Obesity, hyperlipidaemia and diabetes mellitus were the most frequent of the risk factors on the patients with hypertension. Asthma cardiale and acute arrhythmias were slightly more frequent early complications and cardial decompensation was a slightly more frequent late complication. The number of myocardial reinfarctions was the same both in the case of hypertensive and normotensive patients under the circumstances of parallel normalization and keeping the tension and serum cholesterol on the normal level.
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PMID:[Incidence and role of hypertension in the development and recurrence of acute myocardial infarct in a 5-year case load]. 218 98

The present paper focuses on the relation between control beliefs and the compliance of adolescents suffering from chronical diseases. It is assumed that the compliance will be high when the own behavior is regarded as most important for the improvement during illness (internal locus of control). A high compliance is also expected when the own state of health is seen as dependent from other persons, who are engaged in the therapeutic process (powerful others locus of control). Little compliance is expected when the state of health is regarded as dependent from fate or chance influences (chance locus of control). Thereover, it is assumed that the control beliefs are influenced by the specific disease of a patient, since diseases are controllable by the patients in different degrees and therefore should result in specific control beliefs. The theoretical assumptions were proved in an empirical study with 80 patients suffering from different diseases (Diabetes mellitus, Asthma bronchiale, Alopecia areata) and 366 healthy adolescents and adults. The results show a clear dependency of the control beliefs from the kind of disease of the patients. However, the relations between control beliefs and compliance are discrepant to the expectations which is shown mainly by null or negative correlations between internality and compliance. The empirical relations are explained by the self-reliant behavior of the internal patients which perhaps shows little compatibility to traditional concepts of compliance. The implications of the present results for the enhancement of compliance and for the definition of the compliance-concept are elaborated and discussed.
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PMID:[Control beliefs and patient compliance: an empirical study exemplified by adolescents with diabetes mellitus, bronchial asthma and alopecia areata]. 291 90

This study examined the psychosocial adjustment of children with asthma compared to children with diabetes, with cancer, and healthy children and the role of functional status in psychosocial adjustment. The total sample included 100 children, aged 8-16 years, (mean = 11.5 years), consisting of 48 boys and 52 girls. Children with asthma scored significantly higher on measures of affective adjustment (depression and internalizing behavior), significantly lower on self-esteem, and evidenced significantly greater functional impairment. Children with cancer missed significantly more school days. After controlling for functional status, no significant differences remained in affective adjustment but absences remained significantly higher for the children with cancer.
J Asthma 1995
PMID:Psychosocial adjustment and the role of functional status for children with asthma. 755 75

A key informant based survey was done in 1992 to enlist cases of chronic disorders in a rural area of Haryana. Thirty-nine villages selected purposely from a block were surveyed by a trained field worker. He made contacts with key informants like dais, anganwadi workers, health workers, teachers, village elders, etc, to enlist known cases of chronic disorders. In all 812 cases of chronic disease were encountered in 28844 population (28.2/1000). Prevalence of chronic disorders was more in higher age group. Males outnumbered females in younger age group and vice versa for higher age group. Asthma, poliomyelitis, mental illness/retardation were more prevalent in males while hypertension, obesity were reported more in females. Tuberculosis, diabetes, hypertension and asthma were significantly more prevalent in higher age group while poliomyelitis was reported more in children. Consultation rate was high in tuberculosis, asthma, hypertension and diabetes.
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PMID:Estimation of chronic disease load in a rural area of Haryana. 857 91

The association of vitiligo and other skin pigmentary disorders has been well shown with autoimmune diseases, i.e., systemic lupus erythematosus, rheumatoid arthritis. Furthermore, in certain diseases such as diabetes mellitus and adrenal insufficiency the incidence of pigmentation disorders is higher than in the general population. A total of 53 male and 46 female patients with a diagnosis of asthma, based on clinical findings and pulmonary function tests (PFT), were thoroughly examined for the presence of hypopigmented skin lesions and compared with 100 nonasthmatic controls with a similar demographic distribution. The patients were questioned regarding the history of steroid treatment in the past and present and subdivided into five groups based on the duration of therapy. Adrenal gland function was tested by 8:00 A.M. serum cortisol concentration in the group of patients with a history of steroid use as well as in some patients without this history. These patients were also tested for absolute lymphocyte and eosinophil count. Hypopigmented lesions were noted in 36.4% of asthmatic patients and in 11% nonasthmatic controls (p-value < 0.01). There were no differences in the location, but the size of lesions per patient was larger in the asthmatic than the control group. Twenty of 55 patients who had a history of steroid treatment in the past had hypopigmented skin lesions as compared to 16 of 42 patients who had no history of steroid treatment. We conclude that there is a higher coincidence of hypopigmented skin lesions, mainly vitiligo-type in asthmatic patients, compared to the general population, which is not related to a history of steroid treatment or incidence of adrenal insufficiency in these patients.
J Asthma 1996
PMID:Hypopigmented skin lesions associated with atopic dermatitis in asthma. 870 78

Asthma and airways hyperresponsiveness are the respiratory manifestations of sensitization to exogenous materials including protein allergens and chemical sensitizers that may trigger ongoing inflammation and respiratory symptomatology in those people who are predisposed to develop the asthmatic syndrome. That genetics plays a major role in this particular syndrome is without question, since twin studies have shown a greater prevalence of disease for monozygotic as opposed to dizygotic twins. There have been the beginnings of the development of an approach to a number of candidate genes for major genetic input in the asthmatic syndrome. However, unlike cystic fibrosis or even other autoimmune and inflammatory diseases such as juvenile diabetes and/or multiple sclerosis, a single gene or a significant set of major genes may not be easily identified. Rather the small contribution of multiple genes and/or sets of genes may be summed together and added to environmental exposure in people who will develop asthmatic syndromes. The identification of a genetic component to asthma would be of great significance. Even without a major or predominant gene, identification of the minor sets of genes interacting to cause asthma would represent a great advance. Knowledge of those minor genetic alleles involved in asthma susceptibility would allow great latitude in offering diagnostic screening and new therapeutic interventions in asthma.
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PMID:Genetics of asthma and atopy. 871 79

Asthma in pregnancy has been associated with maternal and fetal morbidity and mortality. This study examines the relations of asthma in pregnancy, its severity and its treatment to the labor process, maternal and fetal parameters. Hundred and one consecutive asthmatic women, who gave birth to single babies between November 1993 and November 1994 at the Soroka Medical Center were studied. A group of 77 nonasthmatic women, matched for age and ethnic origin, who gave birth to single babies during the same period served as controls. A larger percentage of asthmatic women suffered from respiratory and urinary tract infections than in the control group (p < 0.001). Severe asthma was associated with a higher rate of infections than milder asthma (p = 0.01). The incidence of smoking was higher among asthmatic women than among controls (p = 0.037). No association was found between socioeconomic status and smoking or infections. No association was found between maternal asthma or maternal use of corticosteroids and the following: maternal hypertension, maternal diabetes, low birth weight (< 2,500 g), preterm delivery (< 37 weeks), adequacy of weight to gestational age and Apgar scores. Three infants with congenital heart defects were born to asthmatic mothers. When the presentation of the fetus was not cephalic, all the asthmatic women were delivered by cesarean section, versus only 60% in the control group (p = 0.08). Labor was induced with oxytocin more often in the asthma group than in the control group (p = 0.07). We conclude that the labor and neonatal outcome in pregnant asthmatic women treated medically is good, even when asthma is severe and when the patient is treated with corticosteroids. There is, however, a relation between asthma in pregnancy, especially if severe, and predisposition to infections.
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PMID:Influence of asthma in pregnancy on labor and the newborn. 958 Sep 25

Asthma management is based on step therapy incorporated into an individualized patient treatment plan. Medication selection is based on differing degrees of asthma severity. With proper assessment of the patient and a severity level incorporating the patient's needs, a clinician can create a credit card treatment plan for each patient. The assessment should include both PEFR and symptom monitoring as a means of incorporating the CDC's severity guidelines and treatment options into the credit card plan. Evaluation of technique, review of home monitoring outcomes, and reinforcement during clinic visits is likely to be helpful for those patients who do home monitoring. Note, however, that not all patients should be treated using this self-management approach. Asthma associated with comorbidities may be a reason to manage patients more closely either by clinic visit or telephone. Asthma in both older and pregnant patients presents issues of drug safety (Evans, Brown, & Morain, 1997). The common comorbidities of chronic obstructive pulmonary disease, sinusitis, GERD, cardiovascular disease and diabetes present unique issues of difficulty of diagnosis and drug safety. By following individualized asthma management plans, patients should be able to achieve prevention or reduction of chronic symptoms. They should also notice an improvement in physical activity, the reduction or elimination of exacerbations and improved overall satisfaction.
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PMID:Improving self-care in adults with asthma using peak expiratory flow rate home monitoring. 1103 85

This study compares the quality of life of a community sample of people with asthma in South Australia, using population norms, people suffering from other chronic diseases, and a sample of asthma patients from two hospital clinics. A representative population survey was performed by trained interviewers in spring 1995 of 3001 respondents aged > or = 15 years. A physician's diagnosis of current asthma was reported by 299 (9.9%). The hospital clinic sample had a physician's diagnosis and lung function evidence of asthma (n = 293). All completed the SF-36 health survey. Standardized SF-36 scores, adjusted for age, sex, and social class, were significantly lower for respondents with asthma, compared with population norms, across all subscales of the SF-36 (p < 0.05). Physical component summary (PCS) and mental component summary (MCS) scores were not significantly different in people in the community sample with asthma from scores in people with diabetes and arthritis. PCS and MCS scores did not differ for those with similar symptom frequency in the community and hospital asthma samples, except that hospital patients with frequent symptoms had significantly lower MCS scores (p < 0.01). Asthma has a major impact on the health-related quality of life in the community, comparable to other chronic diseases. The SF-36 performs uniformly in asthma in different situations.
J Asthma 2001 May
PMID:Quality of life in asthma: a comparison of community and hospital asthma patients. 1139 60

Asthma is a global public health problem. Even though the prevalence is variable in different parts of the world, including Latin America, asthma morbility is high, particularly in countries with emerging economies. Asthma mortality is unacceptable, especially since it has been estimated that a high percentage of asthma deaths could be prevented. Fortunately, most patients suffer mild persistent asthma, however, there is evidence that asthma is many times underdiagnosed and undertreated. Primary care physicians, family doctors and paediatricians have to deal with the majority of asthma patients together with different medical conditions; such as heart problems, diabetes, and infectious, etcetera. In order to help these physicians in the process of decision making, guidelines have been developed. There are many asthma guidelines; they range from opinion based guidelines (in the past) to a current more evidence based approach. Among GINA, Global Initiative for Asthma, is the most comprehensive and widespread all around the world. More than a guideline, GINA is actually a programme directed at asthma specialists, other health care providers and patients and their families.
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PMID:[Dissemination program of GINA in Mexico]. 1155 94


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