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Criterion-related validity of a new measure of functional ability was conducted according to a causal model based on conceptual models employed in the area of rehabilitative and geriatric medicine. The criteria variables included concurrent diagnosed diseases, global self-rated health, drug consumption and general practitioner (GP) consultations. The measure of functional ability was developed with the intention of achieving a high degree of discrimination among a group of community dwelling elderly. Data were derived from a sample survey of 70-year-old men and women conducted in 1984 in the county of Copenhagen (Denmark). Altogether 366 men and 368 women participated in each of the two phases of the study--a comprehensive medical examination at the county hospital at Glostrup followed by a home visit conducted by an occupational therapist 1-2 weeks later. The analysis included four different unidimensional index scales of functional ability divided into two types, with reduced speed and tiredness as subdimensions. The two scale types were mobility function and lower limb function. Early losses of ability together with global self-rated health were treated as outcome measures of diagnosed chronic diseases. At the same time these outcome measures together with diagnosed diseases were considered to predict drug consumption and GP consultations. It was shown that functional ability as measured by the new index scales were strongly influenced by diagnosed diseases: arteriostenosis and osteoarthrosis in lower extremities, obesity, shoulder impairments and bronchitis among women, and glucose intolerance, arteriostenosis in lower extremities and shoulder impairments among men. Global self-rated health was strongly associated with the new functional ability rating system. Early losses of ability but not self-rated health was a strong predictor for drug consumption and frequent contacts with GP. It is concluded that the new measure of functional ability is suitable for health studies of community dwelling elderly, in particular as a summary statement of the individual's health status.
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PMID:Functional ability of community dwelling elderly. Criterion-related validity of a new measure of functional ability. 143 11

Infections caused by Chlamydia pneumoniae were first described in 1985. The infection can cause common cold, sore throat, hoarseness, cough, headache, fatigue and sometimes influenza-like illness. Examination can indicate serous otitis media, sinusitis, laryngitis, bronchitis and pneumonia. The course can be long and relapsing. The recommended drugs for treatment are tetracycline or erythromycin for at least two weeks. Five verified cases are described in the article, four of them with symptoms from the upper respiratory tract only. It is concluded that Chlamydia pneumoniae is a not unusual cause of upper airway diseases. Up to now the diagnosis can best be verified by micro immunofluorescence. The authors call for a rapid and reliable test for use in physician's office. It is proposed that infections caused by Chlamydia pneumoniae be termed TWAR.
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PMID:[TWAR infection is a common diagnosis in outpatient clinics]. 157 35

A 52-year-old female complained about non-distinct symptoms such as fatigue, night sweats and bone pain. Because of a febrile bronchitis, chest X-ray was performed, which disclosed enlarged hilar nodes and intestinal and acinar pulmonary infiltrates. Endobronchial biopsy and cultures from bronchial aspirate permitted to diagnose infection by legionella concomitant with sarcoidosis. After antibiotic treatment for legionellosis over four weeks, immunosuppressive therapy for sarcoidosis was initiated with glucocorticoids.
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PMID:[Fever, dyspnea]. 232 Aug 8

This study compared recalled physical and emotional sensations during episodes of acute dyspnea across pulmonary disease groups. The convenience sample consisted of 68 subjects with emphysema-bronchitis, asthma, vascular, and restrictive disease. Temporal patterns of physical and emotional sensations before and during episodes of dyspnea were identified. The frequency of sensations was remarkably similar across disease categories with few significant differences identified. Rather than the disease category, the frequency, intensity, and periodicity of the symptom of dyspnea had the greatest effect on the quality and frequency of sensations reported. The intensity of usual dyspnea reported on a visual analog scale varied significantly among groups, p = .026, with asthmatics having the lowest mean score and vascular subjects the highest. Females reported significantly greater usual dyspnea than males, p = .005. The variables of pulmonary disease group, gender, fatigue, and total network of social support were significantly related to usual dyspnea, and pulmonary group, gender, and attendance at Better Breathers classes were significantly related to worst dyspnea.
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PMID:The sensations of pulmonary dyspnea. 363 51

Subjective symptoms and experiences were explored within a group of 146 severe, chronic bronchitis and emphysema patients. Eighty-nine symptoms and experiences, derived from initial interviews with 29 patients, were rated according to the frequency of occurrence during breathing difficulties. Key cluster analyses were used to derive a Bronchitis-Emphysema Symptom Checklist (BESC) measuring 11 symptom categories: Helplessness-Hopelessness, Decathexis, Fatigue, Poor Memory, Peripheral-Sensory Complaints, Dyspnea, Congestion, Sleep Difficulties, Irritability, Anxiety, and Alienation. The BESC symptom categories are highly reliable and the relationships among categories are stable across two subgroups of patients. The BESC provides one way to describe how patients cope with and experience chronic bronchitis and emphysema.
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PMID:Multidimensional analysis of the symptoms of chronic bronchitis and emphysema. 666 2

In order to reduce the strain on the environment from the deposition of waste in landfills and combustion at incineration plants, several governments throughout the industrialized world have planned greatly increased recycling of domestic waste by the turn of the millennium. To implement the plans, new waste recycling facilities are to be built and the number of workers involved in waste sorting and recycling will increase steadily during the next decade. Several studies have reinforced the hypothesis that exposure to airborne microorganisms and the toxic products thereof are important factors causing a multitude of health problems among workers at waste sorting and recycling plants. Workers at transfer stations, landfills and incineration plants may experience an increased risk of pulmonary disorders and gastrointestinal problems. High concentrations of total airborne dust, bacteria, faecal coliform bacteria and fungal spores have been reported. The concentrations are considered to be sufficiently high to cause adverse health effects. In addition, a high incidence of lower back injuries, probably due to heavy lifting during work, has been reported among workers at landfills and incineration plants. Workers involved in manual sorting of unseparated domestic waste, as well as workers at compost plants experience more or less frequent symptoms of organic dust toxic syndrome (ODTS) (cough, chest-tightness, dyspnoea, influenza-like symptoms such as chills, fever, muscle ache, joint pain, fatigue and headache), gastrointestinal problems such as nausea and diarrhoea, irritation of the skin, eye and mucous membranes of the nose and upper airways, etc. In addition cases of severe occupational pulmonary diseases (asthma, alveolitis, bronchitis) have been reported. Manual sorting of unseparated domestic waste may be associated with exposures to large quantities of airborne bacteria and endotoxin. Several work functions in compost plants can result in very high exposure to airborne fungal spores and thermophilic actinomycetes. At plants sorting separated domestic waste, e.g. the combustible fraction of waste composed of paper, cardboard and plastics, the workers may have an increased risk of gastrointestinal symptoms and irritation of the eyes and skin. At such plants the bioaerosol exposure levels are in general low, but at some work tasks, e.g. manual sorting and work near the balers, exposure levels may occasionally be high enough to be potentially harmful. Workers handling the source-sorted paper or cardboard fraction do not appear to have an elevated risk of occupational health problems related to bioaerosol exposure, and the bioaerosol exposure is generally low.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Sorting and recycling of domestic waste. Review of occupational health problems and their possible causes. 761 Mar 83

Transcutaneous stimulation electromyography of the diaphragm was performed in 64 patients suffering from chronic obstructive bronchitis (COB) to evaluate the function of the diaphragmatic muscle. Increased amplitude, area and shorter M-response gave evidence for the muscle fatigue. Changes in the above parameters correlated with the degree of the respiratory insufficiency and pulmonary hypertension. The authors included subcutaneous electrostimulation of the diaphragm in combined treatment of COB patients free of clinical manifestations indicating circulation decompensation. These patients benefited from the stimulation in contrast to COB patients with decompensated circulation who failed to respond to the procedure.
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PMID:[Diaphragmatic muscle fatigue--its diagnosis and treatment]. 798 65

The aim of this study was to analyse the prevalence of mouldy homes and their association with respiratory symptoms and diseases in a subarctic climate. A questionnaire was mailed to a random sample of 2,000 males and females, aged 25-64 yrs, living in the county of Kuopio, Finland. A total of 1,521 (76%) responded and 1,460 were selected for the final analysis. The prevalence of homes with visible mould was 4%; with the odour of mould 5%; with damp spots, visible mould or the odour of mould 15%; and with moisture/ water damage, damp spots, visible mould or the odour of mould 23%. The number of reports of bronchitis, common cold, atopy, allergic rhinitis, rhinitis, fever and chills, hoarseness, fatigue, difficulties in concentration, lumbar backache and stomach ache were strongly associated with living in a damp home. Bronchitis, hoarseness and difficulties in concentration had the strongest associations, with adjusted odds ratios (95% confidence limits) of: 2.04 (1.49-2.78), 2.23 (1.37-3.63) and 2.17 (1.35-3.50), respectively. After controlling for a possible reporting bias by excluding those subjects reporting lumbar backache and recurrent stomach pain, eye irritation and tiredness remained significant. In conclusion, living in a home with mould problems may increase the risk of respiratory infections and symptoms in adults.
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PMID:Home dampness, moulds and their influence on respiratory infections and symptoms in adults in Finland. 898 Sep 78

This study was conducted in Mexico among residents of an area near a recycling plant for zinc and other metallic dusts to find out if these substances produce various adverse health effects in the population that may come in contact with them. The plant is in a municipality close to Monterrey, which is Mexico's third most populous and second most industrialized city. A cross-sectional comparative design was used for the research, which took place from September to November 1994. By means of quota sampling, houses were selected in two areas--one exposed, by virtue of its proximity to the plant, and the other unexposed, which served as a control--until the desired sample size was reached (621 individuals, an average of five per household). In each dwelling, a trained psychology student administered a questionnaire to one of the older family members to gather data on the presence of acute and chronic illnesses, problems during pregnancy, and congenital illnesses among the household members. In the exposed population, 127 questionnaires were completed, providing information on 596 persons; in the unexposed population, data on 743 persons were gathered via 147 questionnaires. The sex and age distributions were similar in the two populations, and the length of residence in their respective area was slightly longer among unexposed individuals. The most frequently reported health problems in the exposed population were irritation of the eyes and upper respiratory tract, allergies, sleep disturbances, bronchitis, fatigue, skin problems, ear infections, and anemia. The prevalence ratios for the exposed versus unexposed populations were significant with regard to skin eruptions and other skin diseases, fatigue, sleep disturbances, upper respiratory infections, ear infections, bronchitis, and allergies. Women from the two groups did not show significant differences in the prevalence of obstetric problems, miscarriages, or children born with congenital deformities or low birthweight. The sensitivity of the questionnaire used to detect health problems was poor, which could have resulted in an underestimation of some disorders. Nevertheless, various types of information bias were controlled, permitting the conclusion that the exposed population had a greater risk of suffering certain diseases and disorders than the unexposed population.
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PMID:[Health status of the population in the vicinity of a waste recycling plant in Mexico]. 950 58

The association between domestic violence and physical health in middle-aged Australian women is investigated via a cross-sectional survey of 14,100 women (45 to 50 years old) who responded to the first Australian Longitudinal Study on Women's Health survey. After adjustment for demographic and health behavior characteristics and menopause status in multivariate analyses, various physical conditions (allergies or breathing problems, pain or fatigue, bowel problems, vaginal discharge, eyesight and hearing problems, low iron, asthma, bronchitis or emphysema, cervical cancer) were associated with domestic violence. The results highlight the link between health and domestic violence in middle-aged women and underscore the need for health professionals to take a full social history from women presenting with physical symptoms.
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PMID:History of domestic violence and physical health in midlife. 1686 29


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