Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0729233 (Thoracic)
 6,478 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Case 1: A 26-year-old primipara, underwent emergency cesarean section because of premature rupture of membrane and breech presentation in her 36th week of gestation. She had no history of asthma, but physical examination revealed atopic dermatitis in the neck and the arms. Case 2: A 21-year-old woman underwent removal of ovarian cyst. She had a history of asthma in her childhood. On physical examination there was no abnormal findings. For both cases spinal anesthesia was uneventfully induced using 2 and 3 ml of 0.4% tetracaine in 10% dextrose respectively. Sensory loss to cold extended to T3 in both cases. Immediately after the anesthesia reached two level, the first patient began to cough and the second patient complained of difficulty in breathing, and then both became dyspneic in 10-15 minutes thereafter. Wheezing rhonchi was audible in both cases. Both patients recovered fully with antiasthmatic therapy. There was no shock, nor change of the skin and the mucosa. The baby also had no problem postoperatively. Skin reaction to intradermal injection of 0.025 ml of 0.4-0.00004% tetracaine in normal saline was tested on two patients and on eleven volunteers. At higher concentrations it resulted in positive in the patients and all the volunteers, and at lower concentrations it resulted in positive in case 2 and under-positive in case 1 and three volunteers having histories of allergic disease. Skin testing alone does not offer any diagnostic of tetracaine allergy, because tetracaine might be a chemical irritant. Thoracic adrenergic nerve blockade due to spinal anesthesia might trigger asthmatic attack by influencing the cholinergic ganglia of the lung and/or pulmonary blood flow.
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PMID:[Two cases of asthmatic attack caused by spinal anesthesia]. 896 38

The allergens of domestic pets such as cats, dogs and birds, have been known to sensitive predisposed individuals. In Singapore, approximately 25% to 35% of our atopic populations are sensitised to cat, dog or bird feather allergens. It is not known, however, if the presence of such domestic pets would translate to higher rates of sensitisation, or more importantly, give rise to increased respiratory symptoms. This study evaluated the association between the presence of domestic pets at home and the prevalence of respiratory symptoms among asthmatic children in Singapore. The parents of 1517 doctor-diagnosed asthmatic children were interviewed using the American Thoracic Society-Division of Lung Diseases respiratory questionnaire. More than 20% were found to have domestic pets (cats, dogs or birds) at home. Of these, those with exposure to passive smoke in the home were excluded. A total of 188 current pet owners (cats, dogs and birds) were demographically-matched for sex, race and socio-economic status (type of housing) to those without pets, past or current. Compared to those without pets, asthmatic children with pets at home had a higher prevalence of coughing with cold [relative risk (RR) 1.30; 95% confidence interval (CI) 1.01 to 1.69]; wheezing with cold (RR 1.42; CI 1.07 to 1.90), wheezing with shortness of breath (RR 1.33; CI 1.00 to 1.82), exercise-induced wheezing (RR 1.68; CI 1.10 to 2.56); and increased phlegm production or congestion with cold (RR 1.38; CI 1.00 to 1.91). This study suggests that the presence of domestic pets increases the prevalence of respiratory symptoms in asthmatic children. Those with predisposition to these allergens should avoid having these pets in the home or take specific precautions in avoiding their allergens.
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PMID:Presence of domestic pets and respiratory symptoms in asthmatic children. 928 20

Thoracic tumors have been infrequently reported as a complication of neurofibromatosis-1 (NF1). To determine the prevalence and clinical features of thoracic tumors seen in children with NF1, we reviewed medical records and imaging studies for a group of 260 pediatric patients with NF1 followed in a multidisciplinary NF Center. Extrapleural thoracic tumors were seen in nine patients with NF1, corresponding to a prevalence of 3.5% in this hospital-based series of patients. Pathological studies of the tumors demonstrated plexiform neurofibroma in four cases and neurofibrosarcoma in one case. The remaining four cases were suspected to be plexiform neurofibroma based on clinical features but have not been confirmed histologically. Three patients presented with symptoms of chest pain, syncope, or wheezing; six patients were asymptomatic at the time of diagnosis of the tumors. Physical findings frequently found in patients with thoracic tumors were scoliosis (especially focal scoliosis) and visible plexiform neurofibromas of the neck. We conclude that NF1 patients presenting with any of these signs and symptoms should be screened for thoracic tumors with chest X-ray and magnetic resonance imaging as needed. It is unknown whether screening asymptomatic NF1 patients with chest X-rays on a regular basis will result in an improved outcome.
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PMID:Thoracic tumors in children with neurofibromatosis-1. 934 7

This survey was part of a health monitoring system operated in the vicinity of a new power plant in Israel. The aim of this analysis was to determine whether a temporal trend of increased prevalence of asthma can be observed among cohorts of same-aged children, between 1980 and 1989. Schoolchildren were followed up between 1980 and 1989. They performed pulmonary function tests (PFTs), and their parents filled out American Thoracic Society-National Heart and Lung Institute (ATS-NHLI) health questionnaires. This report deals with the changes in the prevalence of asthma, related respiratory conditions and PFT in four cross-sectional data sets gathered among eighth-grade schoolchildren (aged 13-14 yrs). A highly significant (p=0.0005) increase in the prevalence of asthma (from 5.6% in 1980 to 11.2% in 1989), and of wheezing accompanied by shortness of breath (p=0.0009) could be observed. A similar trend could not be found for the prevalence of bronchitis among these children. PFTs of children suffering from asthma or from wheeze accompanied by shortness of breath were lower than those of healthy children. Changes in prevalence of background variables over time could not explain these findings. The significant rise in the prevalence of asthma coupled with reduced pulmonary function test results among asthmatic children, seems to reflect a true increase in morbidity. Temporal changes in the prevalence of background variables as well as proximity to the power plant could not explain this trend.
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PMID:Changing prevalence of asthma among schoolchildren in Israel. 938 54

The rapid methacholine challenge test using a pocket turbine spirometer (Micro Spirometer) and the Spira Elektro 2 dosimeter was performed with 230 consecutive patients who had dyspnoea, wheezing or a prolonged cough of unknown cause. Patients with previous asthma diagnoses as well as those who had used inhaled steroids during the preceding 4 weeks were excluded. Seventy-eight patients (34%) were methacholine positive (PD20FEV1 < or = 6900 micrograms) 47 (60%) of whom had a final diagnosis of American Thoracic Society (ATS) criteria fulfilling bronchial asthma. One hundred and fifty-two patients (66%) were methacholine negative (PD20FEV1 > 6900 micrograms) 14 (9%) of whom had bronchial asthma according to clinical evaluation. Increased bronchial responsiveness was strongly associated with ATS criteria fulfilling asthma (P < 0.0001). When PD20FEV1 was used, 47 (77%) of the asthmatic patients were hyper-responsive (range 40-6900 micrograms) compared to 31 (18%) of the non-asthmatic patients (range 160-6900 micrograms). When using PD15FEV1, 51 (84%) of the asthmatic patients (range 28-6900 micrograms) and 52 (31%) of the non-asthmatic patients (range 100-6900 micrograms) were hyper-responsive. The level of bronchial responsiveness measured by both PD20FEV1 and PD15FEV1 differed significantly between asthmatic and non-asthmatic patients (P < 0.0001). Hyper-responsiveness was associated with an increased daily variation in peak expiratory flow (PEF) (P < 0.0001) and an increased number of blood eosinophils (P < 0.0001). Hyper-responsiveness was also associated with decreased levels of FEV1 and percentages of predicted FEV1 (P = 0.04 and P < 0.0001, respectively). Stepwise logistic regression analysis showed that the number of positive prick results (OR = 1.15, 95% CI 1.01-1.31), blood eosinophils (1.004, 1.00-1.01), level of FEV1 (0.56, 0.36-0.87) and current smoking (2.36, 1.00-5.59) were factors significantly associated with the probability of hyper-responsiveness. Age, gender, atopy, pets and a history of ex-smoking were not significantly associated with hyper-responsiveness, neither in univariate nor in multivariate analyses. The Bayesian analysis was used to investigate the diagnostic value of the rapid methacholine challenge test. A receiver operator characteristic curve demonstrated that PD20FEV1 separated asthmatic and non-asthmatic patients better than PD15FEV1. The best cutoff value of PD20FEV1 was 6000 micrograms, but the difference from 6900 micrograms was minimal. The best results of the test using a PD20FEV1 cutoff point of 6900 micrograms (PPV: 0.80, NPV: 0.79) were obtained when the pre-test probability was 0.48. The interval security of the test was established by a pre-test probability between 0.19 and 0.78. Maximal positive (0.34) and negative (0.31) final gains were achieved when pre-test probabilities were 0.33 and 0.65, respectively. The cutoff level of 150 micrograms gave 100% of specificity and predictive value of a positive test for clinical asthma diagnosis. The Bayesian analysis approach demonstrated that the test is useful in asthma diagnostics if not performed on patients with lowest or highest probabilities of asthma.
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PMID:A rapid dosimetric methacholine challenge in asthma diagnostics: a clinical study of 230 patients with dyspnoea, wheezing or a cough of unknown cause. 951 22

Asthma is a common cause of childhood morbidity. The objective of the present study was to evaluate the factors associated with increased asthma morbidity among asthmatic children in Singapore. A cohort of primary school children (n = 6,404, aged 6-13 years) were evaluated using the American Thoracic Society and the Division of Lung Diseases of the National Heart, Lung and Blood Institute, USA (ATS-DLD) respiratory questionnaire. A total of 2,222 of 6,404 children (34.8%) was found to have reported symptoms of wheezing. Of these, 899/2,222 (40.5%) reported symptoms of "increased asthma morbidity". This was associated with the younger age group, male sex and higher socio-economic status. In addition, concurrent or past allergies were strongly associated with increased asthma morbidity, while premature birth and a history of prior childhood respiratory illnesses and Infections were predictive of greater asthma morbidity. No association was found between increased morbidity and presence of domestic pets, parental smoking, childcare attendance, and the season of birth.
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PMID:Factors associated with increased respiratory symptoms among asthmatic children in Singapore. 1069 52

Since the introduction of the market economy in 1986, Vietnam has been in the process of rapid economic development. However, the current state of affairs in the industries is very profit-oriented and due consideration is not given to the occupational health services and environmental health. In order to investigate the relationship among occupational exposure to dust/chemicals (toxic gases/fume), environmental pollution and chronic respiratory symptoms in Vietnam, the questionnaire standardized by the American Thoracic Society was applied to 1,562 subjects living in the Quang Ninh area and its surroundings, North Vietnam. Chronic respiratory symptoms such as cough, phlegm, wheezing and breathlessness appeared from the questionnaire. According to the results of multiple logistic regression analyses, among current non-smokers, the odds ratios of chronic respiratory symptoms with a history of occupational exposure to dust, living in polluted district and age were over unity. Especially for cough, significantly higher odds ratios were observed among those with the history of occupational exposure to dust: 2.248 (95% confidential interval: 1.642-3.077). Among current smokers, the odds ratios of chronic respiratory symptoms with the history of occupational exposure to dust were over unity. These results indicate that the history of occupational exposure to dust, living in polluted area and age cause non-smokers to have chronic respiratory symptoms, and also that the history of occupational exposure to dust affect the current smokers.
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PMID:Occupational exposure, environmental pollution and chronic respiratory symptoms in Vietnam. 1113 21

A 24-year-old man who had had bronchial asthma between the ages of 10 and 12 years was admitted to our hospital on October 10, 2000. In May 1999, he had received antituberculosis therapy for left upper lobe infiltrate, which resolved two months later. Chest radiography on admission showed recurrence of the left upper lobe infiltrate. He complained of cough and low grade fever. Thoracic CT demonstrated gloved-finger shadows in the left upper lung field, as well as central bronchiectasis. Wheeze was not ausculated, and flow volume curve revealed no obstructive changes. Total IgE was markedly increased (6,084 IU/ml), and IgE RAST was positive for multiple allergens including Aspergillus species and precipitating antibody test against Aspergillus fumigatus was also positive. Bronchofiberscopy revealed mucoid impaction at the left B1 + 2, and culture of lavage fluid demonstrated Aspergillus fumigatus. A bronchial biopsy at the orifice of the left upper lobe bronchus revealed thickening of the basement membrane, eosinophil infiltration, and marked hypertrophy of the mucus glands. The diagnosis was allergic bronchopulmonary aspergillosis (ABPA), and 30 mg prednisolone was initiated and tapered. The infiltrate detected on chest radiography was resolved. Eight months later, asthmatic symptoms were observed, and Fluticasone dipropionate administration was started. However, the infiltration seen in the chest radiographs have not recurred until now. Asthmatic inflammation of the bronchial mucosa was demonstrated in a case of ABPA without clinical asthma.
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PMID:[Bronchial biopsy in allergic bronchopulmonary aspergillosis without clinical asthma]. 1283 48

In Lebanon, childhood asthma is an important disease and pesticides are commonly used. The objective of this study was to evaluate whether exposure to pesticides has chronic effects on the respiratory health of Lebanese children. A cross-sectional study was performed on children from a randomly selected sample of Lebanese public schools. Exposure to pesticides was evaluated by a standardised questionnaire and a residential exposure score, and respiratory symptoms were assessed by using the American Thoracic Society standardised questionnaire. A chronic respiratory disease was reported in 407 (12.4%) out of 3,291 children. The baseline difference in mean age was small but statistically significant. Any exposure to pesticides, including residential, para-occupational and domestic, was associated with respiratory disease and chronic respiratory symptoms (chronic phlegm, chronic wheezing, ever wheezing), except for chronic cough. Exposure to pesticides was associated with chronic respiratory symptoms and disease among Lebanese children.
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PMID:Respiratory symptoms in children and exposure to pesticides. 1451 43

Exhaled nitric oxide (NO) reflects inflammation in the lower airways and is well adapted for use in children. The aims of this study were to investigate the distribution of the fraction of expired NO (FENO) in school children and to compare FENO and spirometry in relation to the International Study of Asthma and Allergies in Childhood questionnaire. The study was performed in 959 randomly selected 13-14-year-old school children in Uppsala, Sweden. Exhaled NO was measured at an inhalation rate of 0.1 l/s (FENO0.1) and a spirometric test was performed and data from these measurements were related to questionnaire data. Exhaled NO was measured according to American Thoracic Society recommendations, except the use of a mouth wash and an exhalation flow rate of 0.1 l/s. The distribution of the mean FENO0.1 values was skewed, with a preponderance of very low levels and a widespread tail of values ranging up to 102 parts per billion (ppb). Boys exhibited significantly higher mean FENO0.1 values than girls, 5.2 (4.7-5.7) vs 4.4 (4.0-4.8) ppb (geometric mean and 95% CI), P <0.01). Children who reported wheezing in the last year had higher FENO0.1 values than children that had not, 8.5 (7.1-10.2) vs 4.3 (4.0-4.6) ppb, P <0.001). The same association was found to most symptoms indicating hay fever and eczema. In contrast to this, only weak or inconsistent associations were found between asthma and spirometric indices. Exhaled NO levels were found to be independently related to male gender, wheeze and rhinoconjuctivitis but not to current eczema. In conclusion, exhaled NO was closely associated with reported asthma and allergy symptoms whereas spirometric indices such as percent predicted forced expiratory volume in 1 s were not. As most asthma cases in a population are mild, the findings suggest that exhaled NO is a sensitive marker of asthma and allergy.
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PMID:Exhaled nitric oxide in a population-based study of asthma and allergy in schoolchildren. 1572 78


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