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Query: UMLS:C0392680 (shortness of breath)
 5,217 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We have outlined the various bronchodilator medications currently employed in chronic obstructive airways disease. A knowledge of the pharmacology of the lung and the sites of action of these medications should make it possible to combine them in ways that will promote the most benefit for the patient with the least side effects. A logical format for approaching the patient with chronic obstructive airways disease is listed below. Frequently, for the patient with mild or intermittent symptoms of airways obstruction, an inhaled beta agonist will suffice. This may be taken regularly and as needed (for example, prior to vigorous exercise). For patients with more symptoms or those who cannot be controlled on a single agent, a long-acting theophylline preparation should be initiated. Usually, a 12-hour sustained release tablet is preferable. Bedtime dosing may prevent nocturnal shortness of breath. The factors affecting theophylline metabolism should be kept in mind, and theophylline levels should be obtained in those situations where there is an inadequate or inappropriate clinical response. The combination of an oral theophylline and an inhaled beta agonist should suffice in approximately 80 per cent of patients with chronic obstructive airways disease. For those patients who still have symptoms and in whom no other precipitating factor, such as infection or allergy, has been defined, additional therapy can be initiated. For outpatients, this usually consists of the addition of an oral beta agonist, starting at the lowest dose first. If tachyphylaxis appears to be developing, then aerosol atropine or initiation of corticosteroids should be considered. The addition of mucolytics, mist, and chest physiotherapy will frequently reduce the need for additional measures.
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PMID:Pharmacologic approaches to obstructive airway disease. 286 13

Pneumocystis carinii pneumonia occurs at some point in the course of disease in approximately 85 per cent of patients with AIDS. Because of the frequency of P. carinii pneumonia and because it is readily treatable, prompt, accurate, and efficient diagnostic schemes are of extreme importance. The clinical presentation is generally characterized by fever, nonproductive cough, and shortness of breath. Such symptoms in a patient from a recognized HIV transmission category should prompt a diagnostic evaluation to identify P. carinii or other opportunistic infections. A chest radiograph usually provides an objective indication of lung disease. Pulmonary function tests, particularly the DLCO and lung imaging using 67Ga-citrate, are useful screening tests in patients with normal chest films. Examination of sputum induced by inhalation of a mist of hypertonic saline is a very useful means of identifying P. carinii. Bronchoalveolar lavage is nearly 100 per cent sensitive to the presence of P. carinii and should be performed in patients who have a nondiagnostic sputum examination. Transbronchial biopsy increases the overall yield for diagnoses other than P. carinii and should be performed in patients in whom bronchoalveolar lavage does not provide a diagnosis. Because of the effectiveness of sputum examinations and bronchoscopic procedures, open lung biopsy is rarely necessary. Measurements of circulating P. carinii antigen and antibodies are of no help in diagnosis.
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PMID:Diagnosis of Pneumocystis carinii pneumonia. 306 May 25

A 20-year-old woman was exposed to a kerosene mist for five days at an insecticide manufacturing facility. She had shortness of breath, fever, severe hypoxemia, bilateral pulmonary infiltrates, and a notable reduction of diffusion capacity/total lung capacity ratio. Her symptoms and roentgenographic findings resolved rapidly after cessation of exposure and corticosteroid therapy. Whether her roentgenographic findings resulted from a pulmonary injury similar to that seen with aspirate hydrocarbons is unclear. Industrial exposure to hydrocarbon aerosols is a potential health hazard that may result in short-term and long-term pulmonary disability.
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PMID:Hydrocarbon aerosol pneumonitis in an adult. 634 14

The objective of this work was to determine whether the prevalence of respiratory symptoms differed among workers exposed to different types of metal-working fluids. As part of a mandatory surveillance system for occupational illness, from 1988-1994, the Michigan Department of Public Health received, 86 occupational disease reports of work-related asthma secondary to exposure to metal-working fluids. As part of a public health program, follow-up industrial hygiene inspections, including medical interviews of the workforce, were performed at companies where the reported cases had become ill. Metal-working fluids were the second most common cause of work-related asthma reported in the state. Most of the reports were from the automobile industry. Follow-up inspections were conducted at 37 facilities where the individuals with work-related asthma had worked. Seven hundred and fifty-five workers at these facilities were interviewed. Only one facility was above the allowable oil mist standard. Despite the exposure levels being within the legal limits, approximately 20% of the fellow workers of the reported cases had daily or weekly respiratory symptoms suggestive of work-related asthma. Workers exposed to emulsified, semisynthetic, or synthetic machining coolants were more likely to have chronic bronchitis; to have visited a doctor for shortness of breath; to have visited a doctor for a sinus problem; to be bothered at work by nasal stuffiness, runny nose, or sore throat; and to have an increased prevalence of respiratory symptoms consistent with work-related asthma, compared to workers exposed to mineral oil metal-working fluids. These findings were found in individuals who currently smoked, had never smoked or were ex-cigarette smokers. Further research to determine the chemical components or microbial contaminants responsible for these findings is needed.
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PMID:Work-related asthma and respiratory symptoms among workers exposed to metal-working fluids. 925 84

Glycol-based fluids are used in the production of theatrical smokes in theaters, concerts, and other stage productions. The fluids are heated and dispersed in aerosol form to create the effect of a smoke, mist, or fog. There have been reports of adverse health effects such as respiratory irritation, chest tightness, shortness of breath, asthma, and skin rashes. Previous attempts to collect and quantify the aerosolized glycols used in fogging agents have been plagued by inconsistent results, both in the efficiency of collection and in the chromatographic analysis of the glycol components. The development of improved sampling and analytical methodology for aerosolized glycols was required to assess workplace exposures more effectively. An Occupational Safety and Health Administration versatile sampler tube was selected for the collection of ethylene glycol, propylene glycol, 1,3-butylene glycol, diethylene glycol, triethylene glycol, and tetraethylene glycol aerosols. Analytical methodology for the separation, identification, and quantitation of the six glycols using gas chromatography/flame ionization detection is described. Limits of detection of the glycol analytes ranged from 7 to 16 micrograms/sample. Desorption efficiencies for all glycol compounds were determined over the range of study and averaged greater than 90%. Storage stability results were acceptable after 28 days for all analytes except ethylene glycol, which was stable at ambient temperature for 14 days. Based on the results of this study, the new glycol method was published in the NIOSH Manual of Analytical Methods.
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PMID:Determination of glycols in air: development of sampling and analytical methodology and application to theatrical smokes. 1046 79

A team of international occupational health and safety professionals evaluated the working conditions and health status of miners at a giant open-pit copper mine in Cananea, Mexico. Workers in the ore processing plants were exposed to levels of crystalline silica 10 times the Mexican regulatory limit, high levels of acid mist and noise, and numerous safety hazards, including unguarded machinery and malfunctioning 10- and 15-ton cranes. Lung function testing and interviews with physicians showed a substantial percentage of miners with adverse respiratory symptoms including shortness of breath (46%), wheezing (12%), coughing (12%), and elevated sputum production (10%). The mine owner, Grupo Mexico, violated Mexican law by failing to conduct an industrial hygiene survey sufficient to identify, evaluate, and control health hazards including exposure to mineral dust (including silica), acid mists, airborne solvents, high noise levels, high vibration levels, and extreme temperatures.
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PMID:Cananea copper mine: An international effort to improve hazardous working conditions in Mexico. 1926 22